title: Oberlin transfer and partial radial to axillary nerve neurotization to repair an explosive traumatic injury to the brachial plexus in a child: case report.
abstract: OBJECTIVE
  Explosive injuries to the pediatric brachial plexus are exceedingly rare and as such are poorly characterized in the medical literature.
  
  
  METHODS
  Herein, we describe an 8-year-old who was struck in the neck by a piece of shrapnel and suffered multiple vascular injuries in addition to a suspected avulsion of the cervical 5 and 6 ventral rami. The patient had a complete upper brachial plexus palsy and failed to demonstrate any clinical improvement at 6-months follow-up. He was taken to the operating from for a partial ulnar to musculocutaneous nerve neurotization as well as a partial radial to axillary nerve neurotization.
  
  
  RESULTS
  The patient's motor exam improved from a Medical Research Council scale 1 to 4+ for biceps brachii and 0 to 4 deltoid function with greater than 90° of shoulder abduction.
  
  
  CONCLUSIONS
  This outcome supports complex neurotization techniques as viable treatment options for persistent motor deficits following an upper brachial plexus injury in older, non-infant age, children.
authors: Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA, jhmiller@uabmc.edu.
authors: Joseph H
authors: JH
authors: Miller
authors: Sarah T
authors: ST
authors: Garber
authors: Don E
authors: DE
authors: McCormick
authors: Ramin
authors: R
authors: Eskandari
authors: Marion L
authors: ML
authors: Walker
authors: Elias
authors: E
authors: Rizk
authors: R Shane
authors: RS
authors: Tubbs
authors: John C
authors: JC
authors: Wellons
mesh_terms: D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000601:surgery*; D002648:Child; D057645:Deltoid Muscle / Q000294:innervation; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000209:etiology / Q000601:surgery; D018482:Muscle, Skeletal / Q000294:innervation; D016067:Nerve Transfer / Q000379:methods*; D010243:Paralysis / Q000209:etiology / Q000601:surgery*; D011826:Radial Nerve / Q000601:surgery; D020127:Recovery of Function; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications*
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