title: Vascularized Thoracodorsal to Suprascapular Nerve Transfer, a Novel Technique to Restore Shoulder Function in Partial Brachial Plexopathy.
abstract: We describe the clinical outcome of a novel nerve transfer to restore active shoulder motion in upper brachial plexus injury. The thoracodorsal nerve (TDN) was successfully used as a vascularized donor nerve to neurotize to the suprascapular nerve (SSN) in a patient with limited donor nerve availability. At 4 years follow-up, he had regained useful external rotation of the injured limb, with no significant donor site morbidity. Shoulder abduction return was less impressive, however, and reasons for this are discussed. We provide a comprehensive review of the literature on this topic and a subsequent discussion on the details of this novel technique. This is the first reported case of TDN to SSN transfer, and also the first reported case of a vascularized TDN transfer in the English language literature. We advocate direct thoracodorsal to SSN transfer as a valid surgical option for the restoration of shoulder function in patients with partial brachial plexus avulsion, when conventional nerve donors are unavailable.
authors.affiliation: Victorian Plastic Surgery Unit, St Vincent's Private Hospital, Melbourne, VIC, Australia; The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Shirley M
authors.initials: SM
authors.lastname: Potter
authors.affiliation: Victorian Plastic Surgery Unit, St Vincent's Private Hospital, Melbourne, VIC, Australia; The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Scott I
authors.initials: SI
authors.lastname: Ferris
keywords: brachial plexus injury; nerve transfer; suprascapular nerve; thoracodorsal nerve; vascularized nerve