Triceps motor branch transfer for isolated traumatic pediatric axillary nerve injuries.
OBJECTIVE
Transfer of the triceps motor branch has been used for treatment of isolated axillary nerve palsy in the adult population. However, there are no published data on the effectiveness of this procedure in the pediatric population with traumatic injuries. The authors reviewed demographics and outcomes in their series of pediatric patients who underwent this procedure.


METHODS
Six patients ranging in age from 10 to 17 years underwent triceps motor branch transfer for the treatment of isolated axillary nerve injuries between 4 and 8 months after the inciting injury. Deltoid muscle strength was evaluated using the modified British Medical Research Council (MRC) grading system. Shoulder abduction at last follow-up was measured.


RESULTS
The mean duration of follow-up was 38 months. The average postoperative MRC grading of deltoid muscle strength was 3.6 ± 1.3. The median MRC grade was 4. One patient who did not achieve an MRC grade of 3 suffered multiple injuries from high-velocity trauma. Unlike in the adult population, age, body mass index of the patient, and delay from injury to surgery were not significant factors affecting the outcome of the procedure.


CONCLUSIONS
In the pediatric population with traumatic injuries, isolated axillary nerve injury treated with triceps motor branch transfer can result in good outcomes.
Division of Hand Surgery, Department of Orthopedic Surgery, and.
Harvey
H
Chim
Michelle F
MF
Kircher
Robert J
RJ
Spinner
Allen T
AT
Bishop
Alexander Y
AY
Shin
D000063:Accidents, Traffic; D000293:Adolescent; D001365:Axilla / Q000294:innervation*; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology; D002648:Child; D004525:Efferent Pathways / Q000601:surgery*; D004576:Electromyography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000294:innervation*; D016067:Nerve Transfer / Q000379:methods*; D019637:Orthopedic Procedures / Q000009:adverse effects; D059348:Peripheral Nerve Injuries / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery; D012865:Skiing; D016896:Treatment Outcome
BMI = body mass index; MRC = Medical Research Council; MVA = motor vehicle accident; axillary nerve injury; nerve transfer; peripheral nerve; triceps motor branch