Shoulder abduction reconstruction for C5-7 avulsion brachial plexus injury by dual nerve transfers: spinal accessory to suprascapular nerve and partial median or ulnar to axillary nerve.

Journal of Plastic Surgery and Hand Surgery
Gavrielle Hui-Ying Kang, Fok-Chuan Yong

Abstract

Results of shoulder abduction reconstruction in partial upper-type brachial plexus avulsion injuries are better when a triceps nerve is transferred to the axillary nerve in addition to the spinal accessory to suprascapular nerve transfer. However, in C5-7 avulsion injuries, the triceps nerve may be unavailable as a donor nerve. We report the results of an alternative neurotization to the axillary nerve using either a partial median or ulnar nerve. Patients with C5, 6 ± 7 avulsion injuries and weak triceps who underwent dual nerve transfers for shoulder abduction reconstruction were recruited for the study. The second neurotization to the axillary nerve was from either a partial median or ulnar nerve that had an expandable muscle innervation of ≥ M4 motor power. Patients were assessed for recovery of shoulder abduction and external rotation. Nine patients (median age = 23 years) underwent these dual neurotizations from March 2005 to April 2013. The median time to surgery was 4.5 months. Recovery of shoulder abduction averaged 114.4° (range 90°-180°) and external rotation averaged 136.3° (range 135°-140°). Final shoulder abduction power was > M3 in all 9 patients and ≥ M4 in 6 patients. One patient with partial median nerve trans...Continue Reading

References

Sep 12, 2001·Clinical Orthopaedics and Related Research·X ZhaoJ Lao
Jan 26, 2005·Hand Clinics·Panupan SongcharoenRobert J Spinner
Feb 14, 2006·The Journal of Hand Surgery·Somsak LeechavengvongsKanchai Malungpaishrope
Aug 19, 2007·Journal of Neurosurgery·Jayme Augusto BertelliMarcos Flávio Ghizoni
Sep 11, 2007·The Journal of Hand Surgery·Jayme Augusto Bertelli, Marcos Flávio Ghizoni

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