Phrenic nerve transfer in the restoration of elbow flexion in brachial plexus avulsion injuries: how effective and safe is it?

Neurosurgery
Mario G Siqueira, Roberto S Martins

Abstract

Phrenic nerve transfer has been used for treating lesions of the brachial plexus since 1970. Although, today, surgeons are more experienced with the technique, there are still widespread concerns about its effects on pulmonary function. This study was undertaken to evaluate the effectiveness and safety of this procedure. Fourteen patients with complete palsy of the upper limb were submitted to phrenic nerve transfer as part of a strategy for surgical reconstruction of their plexuses. Two patients were lost to follow-up, and 2 patients were followed for less than 2 years. Of the remaining 10 patients, 9 (90%) were male. The lesions affected both sides equally. The mean age of the patients was 24.8 years (range, 14-43 years), and the mean interval from injury to surgery was 6 months (range, 3-9 months). The phrenic nerve was always transferred to the musculocutaneous nerve, and a nerve graft (mean length, 8 cm; range, 4.5-12 cm) was necessary in all cases. There was no major complication related to the surgery. Seven patients (70%) recovered functional level biceps strength (Medical Research Council grade >or=3). All of the patients exhibited a transient decrease in pulmonary function tests, but without clinical respiratory probl...Continue Reading

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Citations

Jul 19, 2011·Journal of Neurosurgery·Haodong LinDesong Chen
Sep 11, 2012·Journal of Neurosurgery·Chaturong PornrattanamaneewongSaichol Wongtrakul
Nov 22, 2008·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Gottfried WechselbergerThomas Schoeller
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Feb 16, 2021·Journal of Brachial Plexus and Peripheral Nerve Injury·Kazuteru DoiSotetsu Sakamoto
Jan 27, 2020·World Neurosurgery·Wei DingLei Xu
Mar 14, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Hamid NamaziDehghani Nazhvani Fatemeh
Jan 30, 2021·Journal of Neurosurgery·Roberto Sergio MartinsManoel Jacobsen Teixeira

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