title: Outcome of contralateral C7 transfer to two recipient nerves in 22 patients with the total brachial plexus avulsion injury.
abstract: The treatment of total brachial plexus avulsion injury is difficult with unfavorable prognosis. This report presents our experience on the contralateral C7 (CC7) nerve root transfer to neurotize two recipient nerves in the patients with total BPAI. Twenty-two patients underwent CC7 transfer to two target nerves in the injured upper limb. The patients' ages ranged from 13 to 48 years. The entire CC7 was transferred to pedicled ulnar nerve in the first stage. The interval between trauma and surgery ranged from 1 to 13 months. The ulnar nerve was transferred to recipients (median nerve and biceps branch or median nerve and triceps branch) at 2-13 months after first operation. The motor recovery of wrist and finger flexor to M3 or greater was achieved in 68.2% of patients, the sensory recovery of median nerve area recovered to S3 or greater in 45.5% of patients. The functional recovery of elbow flexor to M3 or greater was achieved in 66.7% of patients with repair of biceps branch and 20% of patients with repair of the triceps branch (P < 0.05). There were no statistical differences in median nerve function recovery at comparisons of the age younger and older than 20-years-old and the intervals between trauma and surgery. In conclusion, the use of CC7 transfer for repair two recipient nerves might be an option for treatment of total BPAI. The functional recovery of the repaired biceps branch appeared to be better than that of the triceps branch.
authors.affiliation: Department of Hand Surgery, HuaShan Hospital, Fudan University, Shanghai, China.|Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China.|Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
authors.forename: Kaiming
authors.initials: K
authors.lastname: Gao
authors.affiliation: Department of Hand Surgery, HuaShan Hospital, Fudan University, Shanghai, China.|Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China.|Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lao
authors.affiliation: Department of Hand Surgery, HuaShan Hospital, Fudan University, Shanghai, China.|Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China.|Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Hand Surgery, HuaShan Hospital, Fudan University, Shanghai, China.|Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China.|Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
authors.forename: Yudong
authors.initials: Y
authors.lastname: Gu
mesh_terms: D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D002572:Cervical Plexus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013126:Spinal Nerve Roots / Q000601:surgery*; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000601:surgery; D055815:Young Adult