title: Combined nerve transfers for repair of the upper brachial plexus injuries through a posterior approach.
abstract: The upper brachial plexus injury leads to paralysis of muscles innervated by C5 and C6 nerve roots. In this report, we present our experience on the use of the combined nerve transfers for reconstruction of the upper brachial plexus injury. Nine male patients with the upper brachial plexus injury were treated with combined nerve transfers. The time interval between injury and surgery ranged from 3 to 11 months (average, 7 months). The combined nerve transfers include fascicles of the ulnar nerve and/or the median nerve transfer to the biceps and/or the brachialis motor branch, and the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) and triceps branches to the axillary nerve through a posterior approach. At an average of 33 months of follow-up, all patients recovered the full range of the elbow flexion. Six out of nine patients were able to perform the normal range of shoulder abduction with the strength degraded to M3 or M4. These results showed that the technique of the combined nerve transfers, specifically the SAN to the SSN and triceps branches to the axillary nerve through a posterior approach, may be a valuable alternative in the repair of the upper brachial plexus injury. Further evaluations of this technique are necessary.
authors: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.
authors: Jiuzhou
authors: J
authors: Lu
authors: Jianguang
authors: J
authors: Xu
authors: Wendong
authors: W
authors: Xu
authors: Lei
authors: L
authors: Xu
authors: Yousheng
authors: Y
authors: Fang
authors: Liang
authors: L
authors: Chen
authors: Yudong
authors: Y
authors: Gu
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis / Q000601:surgery*; D002574:Cervical Vertebrae; D015331:Cohort Studies; D004576:Electromyography; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000637:transplantation; D016067:Nerve Transfer / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012785:Shoulder Joint / Q000294:innervation / Q000503:physiopathology; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000637:transplantation; D034941:Upper Extremity / Q000294:innervation; D055815:Young Adult