title: Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury.
abstract: The purpose of this study was to investigate the effectiveness of shoulder function restoration by dual nerve transfers, spinal accessory nerve to the suprascapular nerve and 2 intercostal nerves to the anterior branch of the axillary nerve, in patients with shoulder paralysis that resulted from brachial plexus avulsion injury. It was a retrospective analysis to assess the impact of a variety of factors on reanimation of shoulder functions with dual nerve transfers. A total of 19 patients were included in this study. Most of these patients sustained avulsions of C5, C6, and C7 nerve roots (16 patients). Three of them had avulsions of C5 and C6 roots only. Through a posterior approach, direct coaptation of the intercostal nerves and the anterior branch of the axillary nerve was performed, along with accessory nerve transfer to the suprascapular nerve. Satisfactory shoulder function recovery (93.83° of shoulder abduction and 54.00° of external rotation on average) was achieved after a 62-month follow-up. This dual nerve transfer procedure provided us with a reliable and effective method for shoulder function reconstruction after brachial plexus root avulsion, especially C5/C6/C7 avulsion. The level of evidence is therapeutic IV.
authors.affiliation: From the *Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China; †Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; and ‡Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Chu
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Chen
authors.forename: Yudong
authors.initials: Y
authors.lastname: Gu
authors.forename: Shaonan
authors.initials: S
authors.lastname: Hu
mesh_terms: D000055:Accessory Nerve / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001366:Axillary Artery / Q000294:innervation; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007367:Intercostal Nerves / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012782:Shoulder / Q000502:physiology*; D016896:Treatment Outcome; D055815:Young Adult