title: Surgical treatment for total root avulsion type brachial plexus injuries by neurotization: a prospective comparison study between total and hemicontralateral C7 nerve root transfer.
abstract: OBJECTIVE
  We conducted a clinical study to evaluate the effects of neurotization, especially comparing the total contralateral C7 (CC7) root transfer to hemi-CC7 transfer, on total root avulsion brachial plexus injuries (BPI).
  
  
  METHODS
  Forty patients who received neurotization for BPI were enrolled in this prospective study. Group 1 (n = 20) received hemi-CC7 transfer for hand function, while group 2 (n = 20) received total-CC7 transfer. Additional neurotization included spinal accessory, phrenic, and intercostal nerve transfer for shoulder and elbow function. The results were evaluated with an average of 6 years follow-up.
  
  
  RESULTS
  Group 1 had fewer donor site complications (15%) than group 2 (45%); group 2 had significantly better hand M3 and M4 motor function (65%) than group 1 (30%; P = 0.02). There was no difference in sensory recovery. Significantly, better shoulder function was obtained by simultaneous neurotization on both suprascapular and axillary nerves.
  
  
  CONCLUSIONS
  Total-CC7 transfer had better hand recovery but more donor complications than hemi-CC7. Neurotization on both supra-scapular and axillary nerves improved shoulder recovery.
authors.affiliation: Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Yuan-Kun
authors.initials: YK
authors.lastname: Tu
authors.forename: Yi-Jung
authors.initials: YJ
authors.lastname: Tsai
authors.forename: Chih-Han
authors.initials: CH
authors.lastname: Chang
authors.forename: Fong-Chin
authors.initials: FC
authors.lastname: Su
authors.forename: Chih-Kun
authors.initials: CK
authors.lastname: Hsiao
authors.forename: Jacqueline Siau-Woon
authors.initials: JS
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D016067:Nerve Transfer / Q000379:methods*; D011446:Prospective Studies; D011843:Radiculopathy / Q000601:surgery*; D020127:Recovery of Function; D055815:Young Adult
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