A comparison of intercostal and partial ulnar nerve transfers in restoring elbow flexion following upper brachial plexus injury (C5-C6+/-C7)

The Journal of Hand Surgery
Bertrand CouletMichel Chammas

Abstract

Restoring active elbow flexion is essential in the surgical management of C5-C6 +/- C7 brachial plexus palsies. This study compares the clinical results of 2 techniques to restore elbow flexion: the partial ulnar nerve transfer and the intercostal nerve transfer. Partial ulnar nerve transfer was performed in 23 patients, and intercostal nerve transfer was performed in 17 patients. For both techniques, the transfer to the musculocutaneous nerve was made at the same anatomical point. Age and preoperative delay were comparable between groups of patients. Biceps reinnervation time was significantly earlier (p = .001) in the ulnar nerve technique (mean, 5.1 mo) than the intercostal nerve technique (mean 9.9 mo). Ten of 17 patients recovered useful elbow flexion force (British Medical Research Council grade >M3) in the intercostal nerve transfer group, compared with 20 of 23 patients in the ulnar nerve transfer group. No patient who had surgery more than 6 months after the injury recovered useful elbow flexion force in the intercostal nerve transfer. Elbow flexion strength was better in patients less than 30 years old in the intercostal nerve group. No complications were observed in either group. This study shows that transferring fa...Continue Reading

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Citations

Oct 8, 2013·The Orthopedic Clinics of North America·Roongsak LimthongthangA Lee Osterman
Nov 13, 2012·Chirurgie de la main·H KhalifaC Oberlin
Oct 29, 2011·Clinics in Plastic Surgery·Laurent WehrliDimitri J Anastakis
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Mar 6, 2019·Journal of Neurosurgery·Rajiv Midha, Joey Grochmal
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Jul 30, 2020·The Journal of Hand Surgery Asian-Pacific Volume·Gavrielle Hui-Ying KangFok-Chuan Yong
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Jun 20, 2021·Hand Surgery and Rehabilitation·A Cambon-BinderM-N Thaury

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