title: Recovery of upper extremity function following endoscopically assisted contralateral C7 transfer for obstetrical brachial plexus injury.
abstract: Transfer of the contralateral C7 nerve for reconstruction of the brachial plexus in infants with obstetrical brachial plexus injury has rarely been reported. We developed a new endoscopy-assisted technique via the prevertebral (retroesophageal) route for the transfer of the contralateral C7 nerve in reconstruction of the brachial plexus. The reconstruction was performed in 20 infants (14 boys and six girls). Motor recovery was assessed using the Gilbert and Raimondi scales. The Narakas Sensory Grading System was used to evaluate hand sensation. The mean follow-up period was 45 months (SD 18.2). Of the 20 children, nine had contralateral C7 transfer to lower nerve roots, two had transfer to upper nerve roots and nine had transfer to both upper and lower roots. The postoperative shoulder and elbow functions were good or satisfactory according to the Gilbert classification in all children whose preoperative scores were poor. All patients with lower roots reconstruction (9) had satisfactory hand function. A total of 15 children had a Narakas score of S3. Our technique enables safe contralateral C7 transfer to the avulsed roots in severe obstetrical brachial plexus injury infants with a satisfactory functional recovery.
  
  
  METHODS
  Level IV.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hacettepe University, Ankara, Turkey gurselleblebicioglu@ttmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Leblebicioglu
authors.affiliation: Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Ayhan
authors.affiliation: Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Firat
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hacettepe University, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Uzumcugil
authors.affiliation: Acibadem Ankara Hospital, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yorubulut
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hacettepe University, Ankara, Turkey.
authors.forename: M N
authors.initials: MN
authors.lastname: Doral
mesh_terms: D001720:Birth Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016067:Nerve Transfer; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Obstetrical brachial plexus; contralateral C7; function; rehabilitation; surgery