Reanimation of elbow extension with intercostal nerves transfers in total brachial plexus palsies
- 28 November 2010
- journal article
- research article
- Published by Wiley in Microsurgery
- Vol. 31 (1), 7-11
- https://doi.org/10.1002/micr.20822
Abstract
Background: Restoration of flexion in the elbow is the priority in the management of brachial plexus injuries. Current techniques of reconstructions, combining both nerve grafting and nerve transfer, allow more extensive repair, with additional targets: shoulder, elbow extension, hand. The transfer of intercostal nerves onto the nerve of the triceps long head is used to restore elbow extension. The aim of this retrospective study is to evaluate the results of this procedure, in total brachial plexus palsies with uninjured C5 and C6 roots. Methods: Eleven patients with total brachial plexus injury were reviewed 24 months in average after intercostal nerves transfer. The average age of the patients was twenty-nine years. The average time to surgery after occurrence of the injury was 5 months. Triceps re-innervation and strength of elbow extension were evaluated. Results: The averaged time required for triceps re-innervation after intercostal nerve transfer was 9 months. Seven patients achieved M4 elbow extension according to the Medical Research Council grading system. Two patients achieved M3 elbow extension. Two patients had poor results (M2 and M0). Discussion and conclusions: Transfer of intercostal nerves onto the nerve of the triceps long head is a reliable procedure for the restoration of elbow extension in total brachial plexus palsy. © 2010 Wiley-Liss, Inc. Microsurgery, 2011.Keywords
This publication has 25 references indexed in Scilit:
- Transfer of the Intercostal Nerves to the Nerve of the Long Head of the Triceps to Recover Elbow Extension in Brachial Plexus PalsyTechniques in Hand & Upper Extremity Surgery, 2007
- Ventilation and Exercise Performance After Phrenic Nerve and Multiple Intercostal Nerve Transfers for Avulsed Brachial Plexus InjuryChest, 2005
- Vascularized Ulnar Nerve Graft for Reconstruction of a Large Defect of the Median or Radial Nerves After Severe Trauma of the Upper ExtremityThe Journal of Hand Surgery, 2005
- Glenohumeral arthrodesis in upper and total brachial plexus palsyThe Journal of Bone and Joint Surgery. British volume, 2004
- Use of intercostal nerves for neurotization of the musculocutaneous nerve in infants with birth-related brachial plexus palsyJournal of Neurosurgery, 2001
- Intercostal nerve transfer for brachial plexopathyThe Journal of Hand Surgery, 1994
- Restoration of elbow flexion in root lesions of brachial plexus injuriesThe Journal of Hand Surgery, 1992
- Nerve Repairs for Traumatic Brachial Plexus Palsy With Root AvulsionPublished by Ovid Technologies (Wolters Kluwer Health) ,1988
- Les paralysies de la musculature intrinsèque de la main dans les lésions du plexus brachialAnnales de Chirurgie de la Main, 1986
- A new approach to the intercosto-brachial anastomosis in the treatment of brachial plexus paralysis due to root avulsion. Late resultsActa Neurochirurgica, 1982