JOURNAL ARTICLE

[Clinical application and efficiency of two stage multiple nerves transfer for treatment of root avulsion of brachial plexus]

Guicin Sun, Yudong Gu, Cong Yu, Gaomeng Zhang, Wenjun Li, Xianyou Zheng, Qilin Shi
Chinese Journal of Reparative and Reconstructive Surgery 2005, 19 (6): 450-2
16038460

OBJECTIVE: To investigate the results of two stage multiple nerves transfer for treatment of complete brachial plexus root avulsion.

METHODS: Eight patients with complete brachial plexus avulsion, aging 18-38 years and with a mean 6 months interval of injury and repair, were surgically treated with the following procedures. One stage surgical procedure was that the contralateral C7 never root was transferred to the ulnar nerve, the phrenic nerve to the anterior division of upper trunci plexus brachialis and the accessory nerve to the suprascapular nerve. Two stage surgical procedure was that the ulnar nerve was transferred to the median nerve , the intercostal nerves to the radial nerve and the thoracodorsal nerve.

RESULTS: All patients were followed up from 13 months to 25 months (21 months on average), muscle reinnervation was observed in all patients. Return of muscle power of M3 or better are regarded as effective. The effective recovery results were 75% in musculocutaneous nerve, 37.5% in suprascapular nerve, 37.5% in radial nerve, 75% in thoracodorsal nerve and 62.5% in median nerve. In sensory recovery of the median nerve, 4 patients obtained S3, 3 patients S2 and 1 patient S1.

CONCLUSION: Two stage multiple nerves transfer for treatment of root avulsion of brachial plexus can achieve better motor function results and is safe and effective. The procedure should be recommended for treatment of root avulsion of brachial plexus in selected patients with complete brachial plexus root avulsion, especially in young patients with a short interval between injury and repair. It is one of the alternative options.

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