title: Donor-side morbidity after contralateral C-7 nerve transfer: results at a minimum of 6 months after surgery.
abstract: OBJECT Donor-side morbidity associated with contralateral C-7 (CC7) nerve transfer remains controversial. The purpose of this study was to evaluate functional deficits in the donor limb resulting from prespinal route CC7 nerve transfer. METHODS A total of 63 patients were included. Forty-one patients had undergone CC7 nerve transfer surgery at least 6 months previously and were assigned to one of 2 groups based on the duration of postoperative follow-up. Group 1 (n = 21) consisted of patients who had undergone surgery between 6 months and 2 years previously, and Group 2 (n = 20) consisted of patients who had undergone surgery more than 2 years previously. An additional 22 patients who underwent CC7 nerve transfer surgery later than those in Groups 1 and 2 were included as a control group (Group 3). Results of preoperative testing in these patients and postoperative testing in Groups 1 and 2 were compared. Testing included subjective assessments and objective examinations. An additional 3 patients had undergone surgery more than 6 months previously but had severe motor weakness and were therefore evaluated separately; these 3 patients were not included in any of the study groups. RESULTS The revised Short-Form McGill Pain Questionnaire (SF-MPQ-2) was the only subjective test that showed a significant difference between Group 3 and the other 2 groups, while no significant differences were found in objective sensory, motor, or dexterity outcomes. The interval from injury to surgery for patients with a normal SF-MPQ-2 score in Groups 1 and 2 was significantly less than for those with abnormal SF-MFQ-2 scores (2.4 ± 1.1 months vs 4.6 ± 2.9 months, p = 0.002). The 3 patients with obvious motor weakness showed a tendency to gradually recover. CONCLUSIONS Although some patients suffered from long-term sensory disturbances, resection of the C-7 nerve had little effect on the function of the donor limb. Shortening preoperative delay time can improve sensory recovery of the donor limb.
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.|Department of Orthopedic Surgery, First Affiliated Hospital of Henan University of Science and Technology, Luoyang, Henan, China.
authors.forename: Xiang-Ming
authors.initials: XM
authors.lastname: Li
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.
authors.forename: Jian-Tao
authors.initials: JT
authors.lastname: Yang
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.
authors.forename: Yi
authors.initials: Y
authors.lastname: Hou
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.
authors.forename: Ben-Gang
authors.initials: BG
authors.lastname: Qin
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.
authors.forename: Guo
authors.initials: G
authors.lastname: Fu
authors.affiliation: Department of Microsurgery and Orthopedic Trauma, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong; and.
authors.forename: Li-Qiang
authors.initials: LQ
authors.lastname: Gu
mesh_terms: D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D009460:Neurologic Examination; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology*; D013127:Spinal Nerves / Q000637:transplantation*; D060053:Transplant Donor Site; D034941:Upper Extremity / Q000294:innervation; D055815:Young Adult
keywords: BMI = body mass index; CC7 = contralateral C-7 spinal nerve; M-ASES = modified American Shoulder and Elbow Surgeons questionnaire; MHQ = Michigan Hand Outcomes Questionnaire; SF-MPQ-2 = Short-Form McGill Pain Questionnaire; SWM = Semmes-Weinstein monofilament; clinical assessment; contralateral C-7 nerve transfer; donor site morbidity; peripheral nerve; s2PD = static 2-point discrimination