title: Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve: a report of 13 cases.
abstract: In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries. Six of the former group and three of the latter group achieved >90° shoulder abduction. The technique of double neurotization from a single donor nerve provides favourable results in restoring shoulder abduction in avulsion brachial plexus injuries.
  
  
  METHODS
  IV.
authors.affiliation: 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: K W S J
authors.initials: KWSJ
authors.lastname: Huan
authors.affiliation: 2 Department of Hand Surgery, Singapore General Hospital, Singapore.
authors.forename: J S W
authors.initials: JSW
authors.lastname: Tan
authors.affiliation: 2 Department of Hand Surgery, Singapore General Hospital, Singapore.
authors.forename: S H
authors.initials: SH
authors.lastname: Tan
authors.affiliation: 3 Department of Hand and Microsurgery, Tan Tock Seng Hospital, Singapore.
authors.forename: L C
authors.initials: LC
authors.lastname: Teoh
authors.affiliation: 3 Department of Hand and Microsurgery, Tan Tock Seng Hospital, Singapore.
authors.forename: F C
authors.initials: FC
authors.lastname: Yong
mesh_terms: D000055:Accessory Nerve / Q000637:transplantation*; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000601:surgery*; D000071976:Gracilis Muscle / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods; D059348:Peripheral Nerve Injuries / Q000601:surgery*; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000502:physiology; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Double neurotization; avulsion brachial plexus injury; shoulder abduction; spinal accessory nerve neurotization