Direct Coaptation of the Phrenic Nerve With the Posterior Division of the Lower Trunk to Restore Finger and Elbow Extension Function in Patients With Total Brachial Plexus Injuries

Neurosurgery
Shu-feng WangYu-cheng Li

Abstract

To overcome the mismatch in nerve sizes in phrenic nerve transfer to the radial nerve for elbow and finger extension reanimation for patients with total brachial plexus injuries (TBPI), a selective neurotization procedure was designed. To investigate the long-term results of phrenic nerve transfer to the posterior division of the lower trunk with direct coaptation in restoring elbow and finger extension after TBPI. Phrenic nerve was transferred to and directly coapted with the posterior division of the lower trunk in 27 patients with TBPI. Seven patients were <18 years old (adolescent group), and the remaining 20 patients ≥18 years (adult group). Postoperative mean follow-up period was 54 ± 9 months (range, 48-85 months). The motor function attained M3 or greater in 81.5% of patients for elbow extension and in 48% of patients for finger extension. The percentage of patients who regained M3 or greater muscle power of finger extension in the adolescent group and the adult group was 71.4%, and 40%, respectively. Meanwhile, 85.7% in the adolescent group and 80% in the adult group achieved M3 or greater muscle power of elbow extension. There were no significant differences between the 2 groups. The elbow extension and finger extensi...Continue Reading

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Citations

Sep 6, 2017·The Journal of Hand Surgery, European Volume·Feng LiWen-Jun Li
Dec 22, 2020·Annals of Plastic Surgery·Tarek Abdalla El-GammalYousif Tarek El-Gammal
Apr 6, 2021·Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India·V PurushothamanR Venkataswami
Mar 13, 2021·Journal of Neurosurgical Sciences·Mariano Socolovsky, Martijn Malessy

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