title: Full-length phrenic nerve transfer as the treatment for brachial plexus avulsion injury to restore wrist and finger extension.
abstract: BACKGROUND
  The functional restoration of wrist and finger extension after complete brachial plexus avulsion injury remains an unsolved problem. We conducted a prospective study to elucidate a new method for resolving this injury.
  
  
  METHODS
  Six patients with complete brachial plexus avulsion injury underwent a new surgical procedure in which the full-length phrenic nerve was transferred to the medial portion of the radial nerve at the level of the latissimus dorsi insertion via endoscopic thoracic surgery.
  
  
  RESULTS
  In 5 patients, extensor carpi ulnaris and extensor carpi radialis strength recovered to Medical Research Council grade ≥M3, and in 4 patients extensor digitorum strength recovered to ≥M3.
  
  
  CONCLUSIONS
  Neurotization of phrenic nerve to the medial portion of the radial nerve at the level of latissimus dorsi insertion is a feasible means of restoring wrist and finger extension in cases of complete brachial plexus avulsion injury.
authors.affiliation: Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai 200003, PR China.
authors.forename: Haodong
authors.initials: H
authors.lastname: Lin
authors.forename: Chunlin
authors.initials: C
authors.lastname: Hou
authors.forename: Desong
authors.initials: D
authors.lastname: Chen
mesh_terms: D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000534:rehabilitation / Q000601:surgery*; D004576:Electromyography; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005385:Fingers / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010791:Phrenic Nerve / Q000502:physiology / Q000637:transplantation*; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D014953:Wrist / Q000502:physiology*; D055815:Young Adult