Restoration of shoulder function with nerve transfers in traumatic brachial plexus palsy patients

Microsurgery
Julia K TerzisPanayotis N Soucacos

Abstract

Shoulder stabilization is of utmost importance in upper extremity reanimation following paralysis from devastating injuries. Although secondary procedures such as tendon and muscle transfers have been used, they never achieve a functional recovery comparable to that following successful reinnervation of the supraspinatus, deltoid, teres minor, and infraspinatus muscles. Early restoration of suprascapular and axillary nerve function through timely brachial plexus reconstruction offers a good opportunity to restore shoulder-joint stability, adequate shoulder abduction, and external rotation function. Overall, in our series, 79% of patients achieved good and excellent shoulder abduction (muscle grade, +3 or more), and 55% of patients achieved good or excellent shoulder external rotation after reinnervation of the suprascapular nerve. The best results were seen when direct neurotization of the suprascapular nerve from the distal spinal accessory nerve or neurotization by the C5 root was carried out. Concomitant neurotization of the axillary nerve yields improved outcomes in shoulder abduction and external rotation function.

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Citations

Mar 2, 2013·Hand : Official Journal of the American Association for Hand Surgery·Wilson Z RaySusan E Mackinnon
Oct 31, 2008·Plastic and Reconstructive Surgery·Julia K Terzis, Zinon T Kokkalis
Mar 26, 2009·Plastic and Reconstructive Surgery·Julia K Terzis, Zinon T Kokkalis
Jan 6, 2010·Plastic and Reconstructive Surgery·Julia K Terzis, Antonia Barmpitsioti
Jul 16, 2013·Journal of Neurosurgery·Pavel HaninecRadek Kaiser
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Feb 2, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Julia K Terzis, Antonia Barmpitsioti
Feb 24, 2010·Injury·Marios D VekrisPanayotis N Soucacos
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Sep 3, 2021·The Journal of Hand Surgery, European Volume·Dominic M PowerTahseen Chaudhry

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