title: Intercostal nerve transfer to neurotize the musculocutaneous nerve after traumatic brachial plexus avulsion: a comparison of two, three, and four nerve transfers.
abstract: The purpose of this study was to compare the outcomes of different numbers of intercostal nerve (ICN) transfers for elbow flexion and to determine whether age, body mass index (BMI), type of injury, and preoperative delay influence the outcomes. From 2004 to 2010, 32 (30 included) consecutive patients underwent ICN transfer to the musculocutaneous nerve following brachial plexus injury. Elbow flexion strength was evaluated according to the British Medical Research Council (BMRC) grading system. Of nine patients who received two ICN transfers, six (66.7%) recovered with useful elbow flexion compared with 14 of 17 (82.4%) patients who received three ICN transfers. Of the four patients with four ICN transfers, three (75%) achieved useful recovery. Statistical analysis showed no significant difference. There is no significant difference among the outcomes of two, three, and four ICN transfers to the musculocutaneous nerve. Two ICN transfers are sufficient for useful recovery of elbow flexion. Younger patients achieve better results.
authors.affiliation: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Chengwei
authors.initials: C
authors.lastname: Xiao
authors.affiliation: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lao
authors.affiliation: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yudong
authors.initials: Y
authors.lastname: Gu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007367:Intercostal Nerves / Q000601:surgery / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation* / Q000503:physiopathology; D009138:Musculocutaneous Nerve / Q000503:physiopathology* / Q000601:surgery; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods*; D009431:Neural Conduction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome