title: End-to-side neurorrhaphy in brachial plexus reconstruction.
abstract: OBJECTIVE
  Although a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy (ETSN) have been published to date, there is still a considerable lack of clinical trials investigating this technique. Here, the authors describe their experience with ETSN in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy.
  
  
  METHODS
  From 1999 to 2007, out of 791 reconstructed nerves in 441 patients treated for brachial plexus injury, the authors performed 21 axillary and 2 musculocutaneous nerve sutures onto the median, ulnar, or radial nerves. This technique was only performed in patients whose donor nerves, such as the thoracodorsal and medial pectoral nerves, which the authors generally use for repair of axillary and musculocutaneous nerves, respectively, were not available. In all patients, a perineurial suture was carried out after the creation of a perineurial window.
  
  
  RESULTS
  The overall success rate of the ETSN was 43.5%. Reinnervation of the deltoid muscle with axillary nerve suture was successful in 47.6% of the patients, but reinnervation of the biceps muscle was unsuccessful in the 2 patients undergoing musculocutaneous nerve repair.
  
  
  CONCLUSIONS
  The authors conclude that ETSN should be performed in axillary nerve reconstruction but only when commonly used donor nerves are not available.
authors.affiliation: Third Faculty of Medicine, Charles University, Department of Neurosurgery, Hospital Kralovske Vinohrady, Prague, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Haninec
authors.forename: Libor
authors.initials: L
authors.lastname: Mencl
authors.forename: Radek
authors.initials: R
authors.lastname: Kaiser
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009138:Musculocutaneous Nerve / Q000293:injuries / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult