PMID: 9161548Jan 1, 1997Paper

Paralysis of the brachial plexus caused by supraclavicular injuries in the adult. Long-term comparative results of nerve grafts and transfers

Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
Y AllieuM C Picot

Abstract

Recovery of active elbow flexion constitutes the first priority in microsurgical repair after closed injuries of the supraclavicular brachial plexus in adults. However, there are many controversial issues between the proponents of nerve grafting from available roots, and the proponents of nerve transfer. The results concerning elbow flexor muscle recovery following microsurgical nerve repair of supraclavicular brachial plexus lesions were analysed in 62 patients. The average age at operation was 23 years old and the average delay between trauma and nerve repair was 7 months. Nerve grafting from C5 or C6 was performed in 43 patients. Nerve transfer using 3 intercostal nerves was done in 10 patients and using the spinal accessory nerve in 7 patients. A combination of both techniques was performed in 2 patients. Conventional sural nerve grafts were used every time. Functional evaluation was based on the assessment of active range of motion including flexion and supination, and on the assessment of maximum isotonic strength of the elbow flexors. With an average follow up of 8.5 years (range from 3 to 16 years) the average functional score of the elbow flexors was 4.4 out of a possible 11. Sixty six percent of patients had a strengt...Continue Reading

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