Intercostal nerve crossing to restore elbow flexion and sensibility of the hand for a root avulsion type of brachial plexus injury

Ten patients with a root avulsion type of brachial plexus injury were treated with simultaneous intercostal nerve crossing to the musculocutaneous and median nerves, and nine cases were followed for more than 40 months. The average interval from injury to surgery was 2.7 months. The average age at operation was 18.6 years. The elbow flexor was M4 in six patients, M3 in two patients, and M1 in one patient. The wrist flexor was more than M3 in six patients and less than M2 in four patients. The finger flexor was more than M3 in four patients and less than M2 in five patients. Protective sensation in the areas innervated by the musculocutaneous and median nerves was restored in all cases.