title: Collateral branches of the brachial plexus as donors in nerve transfers.
abstract: OBJECTIVE
  Nerve transfers in cases of directly irreparable, or high level extensive brachial plexus traction injuries are performed using a variety of donor nerves with various success but an ideal method has not been established. The purpose of this study was to analyze the results of nerve transfers in patients with traction injuries to the brachial plexus using the thoracodorsal and medial pectoral nerves as donors.
  
  
  METHODS
  This study included 40 patients with 25 procedures using the thoracodorsal nerve and 33 procedures using the medial pectoral nerve as donors for reinnervation of the musculocutaneous or axillary nerve. The results were analyzed according to the donor nerve, the age of the patient and the timing of surgery.
  
  
  RESULTS
  The total rate of recovery for elbow flexion was 94.1%, for shoulder abduction 89.3%, and for shoulder external rotation 64.3%. The corresponding rates of recovery using the thoracodorsal nerve were 100%, 93.7% and 68.7%, respectively. The rates of recovery with medial pectoral nerve transfers were 90.5%, 83.3% and 58.3%, respectively. Despite the obvious differences in the rates of recovery, statistical significance was found only between the rates and quality of recovery for the musculocutaneous and axillary nerve using the thoracodorsal nerve as donor.
  
  
  CONCLUSIONS
  According to our findings, nerve transfers using collateral branches of the brachial plexus in cases with upper palsy offer several advantages and yield high rate and good quality of recovery.
authors: Neurosurgical Clinic, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Miroslav
authors: M
authors: Samardzić
authors: Lukas
authors: L
authors: Rasulić
authors: Novak
authors: N
authors: Lakićević
authors: Vladimir
authors: V
authors: Bascarević
authors: Irena
authors: I
authors: Cvrkota
authors: Mirko
authors: M
authors: Mićović
authors: Andrija
authors: A
authors: Savić
mesh_terms: D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery*; D002648:Child; D004551:Elbow Joint / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012785:Shoulder Joint / Q000502:physiology*; D013900:Thoracic Nerves / Q000601:surgery; D055815:Young Adult