[Repairing brachial plexus root avulsion by nerve transfer].

OBJECTIVE: To summarize the experience of surgical treatment of brachial plexus root avulsion and to discuss the operations for different of types brachial plexus root avulsion.

METHODS: We enrolled 18 cases of brachial plexus root avulsion with different surgical treatment by nerve transfer from October, 1998 to September, 2002. The follow-up time between 2 years 2 months to 5 years 8 months, the mean time being 3 years 10 months.

RESULTS: The 18 patients were followed up more than 2 years. Of the 16 patients who lost shoulder abduction 11 had recovered to more than grade 3 strength of supraspinatus muscle; 4 had recovered to more than grade 3 strength of deltoid muscle. Of the 16 patients who lost elbow flexor function 14 had recovered to more than grade 3 strength of biceps muscle. Of the 6 patients who lost wrist and finger flexion, 2 had recovered to more than grade 3 strength in flexion of wrist and fingers. Of the 4 patients who lost radial nerve function, 3 had recovered to more than grade 3 strength of extend elbow and finger. All of them had recovered grade 3 strength of extend wrist.

CONCLUSION: Accurate diagnosis, early operation and refine manipulation are key factors for functional recovery in transferring nerve treatment for brachial plexus root avulsion. Different methods should be selected according to the types of brachial plexus avulsion. All injured nerves should be repaired for young patients.