Neurotisation du nerf du chef long du muscle triceps sur le nerf axillaire, dans les paralysies isolées du deltoïde

Teissier, Philippe; Lazerges, Cyril; Marès, Olivier; Bosch, C.; Chammas, Michel

doi:10.1016/j.main.2012.08.007

Cited by 10 publications

(3 citation statements)

References 23 publications

(30 reference statements)

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“…These authors pointed out that the motor branch to the triceps long head stemmed either from the axillary nerve or from the posterior cord. Present findings, previous cadaveric studies, and clinical series on nerve transfers using the triceps long head motor branch for axillary nerve reconstruction refute the observations reported by de Sèze et al [4][5][6][7][8]11,[16][17][18] We recognized two branches to the triceps lateral head, in conformity with previous reports. 4,5 In contrast, Al-Meshal and Gilbert 12 observed multiple branches to the triceps lateral head.…”

Section: Discussionsupporting

confidence: 92%

Triceps and cutaneous radial nerve branches investigated via an axillary anterior arm approach: new findings in a fresh-cadaver anatomical study

Bertelli

Goklani

Patel

et al. 2022

Journal of Neurosurgery

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OBJECTIVE The authors sought to describe the anatomy of the radial nerve and its branches when exposed through an axillary anterior arm approach. METHODS Bilateral upper limbs of 10 fresh cadavers were dissected after dyed latex was injected into the axillary artery. RESULTS Via the anterior arm approach, all triceps muscle heads could be dissected and individualized. The radial nerve overlaid the latissimus dorsi tendon, bounded by the axillar artery on its superior surface, then passed around the humerus, together with the lower lateral arm and posterior antebrachial cutaneous nerve, between the lateral and medial heads of the triceps. No triceps motor branch accompanied the radial nerve’s trajectory. Over the latissimus dorsi tendon, an antero-inferior bundle, containing all radial nerve branches to the triceps, was consistently observed. In the majority of the dissections, a single branch to the long head and dual innervations for the lateral and medial heads were observed. The triceps long and proximal lateral head branches entered the triceps muscle close to the latissimus dorsi tendon. The second branch to the lateral head stemmed from the triceps lower head motor branch. The triceps medial head was innervated by the upper medial head motor branch, which followed the ulnar nerve to enter the medial head on its anterior surface. The distal branch to the triceps medial head also originated near the distal border of the latissimus dorsi tendon. After a short trajectory, a branch went out that penetrated the medial head on its posterior surface. The triceps lower medial head motor branch ended in the anconeus muscle, after traveling inside the triceps medial head. The lower lateral arm and posterior antebrachial cutaneous nerve followed the radial nerve within the torsion canal. The lower lateral brachial cutaneous nerve innervated the skin over the biceps, while the posterior antebrachial cutaneous nerve innervated the skin over the lateral epicondyle and posterior surface of the forearm. The average numbers of myelinated fibers were 926 in the long and 439 in the upper lateral head and 658 in the upper and 1137 in the lower medial head motor branches. CONCLUSIONS The new understanding of radial nerve anatomy delineated in this study should aid surgeons during reconstructive surgery to treat upper-limb paralysis.

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Section: Discussionsupporting

confidence: 92%

Triceps and cutaneous radial nerve branches investigated via an axillary anterior arm approach: new findings in a fresh-cadaver anatomical study

Bertelli

Goklani

Patel

et al. 2022

Journal of Neurosurgery

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“…Here, the posterior portion of the deltoid and the teres minor muscles are not targeted because their functions are sufficiently compensated by adjacent muscles and therefore any dispersion of the already limited transferred axons is avoided (Bertelli et al., 2004). Teissier et al. (2012) observed that targeting the common trunk of the axillary nerve only resulted in adequate reinnervation of the posterior deltoid.…”

Section: Shoulder Dysfunctionmentioning

confidence: 99%

Distal nerve transfers for peripheral nerve injuries: indications and outcomes

Bertelli,

Tuffaha,

Sporer

et al. 2024

J Hand Surg Eur Vol

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Distal nerve transfer is a refined surgical technique involving the redirection of healthy sacrificable nerves from one part of the body to reinstate function in another area afflicted by paralysis or injury. This approach is particularly valuable when the original nerves are extensively damaged and standard repair methods, such as direct suturing or grafting, may be insufficient. As the nerve coaptation is close to the recipient muscles or skin, distal nerve transfers reduce the time to reinnervation. The harvesting of nerves for transfer should usually result in minimal or no donor morbidity, as any anticipated loss of function is compensated for by adjacent muscles or overlapping cutaneous territory. Recent years have witnessed notable progress in nerve transfer procedures, markedly enhancing the outcomes of upper limb reconstruction for conditions encompassing peripheral nerve, brachial plexus and spinal cord injuries.

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“…While nerve grafting has been recommended for repair of axillary nerve lesions, 10,18 the triceps motor branch transfer to the axillary nerve for reinnervation of the deltoid muscle, as initially described by Leechavengvongs et al 13,22 for treatment of lesions of the upper trunk, has been increasingly used in lieu of nerve grafting by our group and others 3,7,12,19 for treatment of isolated axillary nerve lesions. The triceps motor branch transfer has the advantage of having the donor nerve much closer to the deltoid, resulting in a shorter distance required for nerve growth to the motor end plate.…”

mentioning

confidence: 99%

Triceps motor branch transfer for isolated traumatic pediatric axillary nerve injuries

Chim¹,

Kircher²,

Spinner

et al. 2015

PED

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OBJECT Transfer of the triceps motor branch has been used for treatment of isolated axillary nerve palsy in the adult population. However, there are no published data on the effectiveness of this procedure in the pediatric population with traumatic injuries. The authors reviewed demographics and outcomes in their series of pediatric patients who underwent this procedure. METHODS Six patients ranging in age from 10 to 17 years underwent triceps motor branch transfer for the treatment of isolated axillary nerve injuries between 4 and 8 months after the inciting injury. Deltoid muscle strength was evaluated using the modified British Medical Research Council (MRC) grading system. Shoulder abduction at last follow-up was measured. RESULTS The mean duration of follow-up was 38 months. The average postoperative MRC grading of deltoid muscle strength was 3.6 ± 1.3. The median MRC grade was 4. One patient who did not achieve an MRC grade of 3 suffered multiple injuries from high-velocity trauma. Unlike in the adult population, age, body mass index of the patient, and delay from injury to surgery were not significant factors affecting the outcome of the procedure. CONCLUSIONS In the pediatric population with traumatic injuries, isolated axillary nerve injury treated with triceps motor branch transfer can result in good outcomes.

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Neurotisation du nerf du chef long du muscle triceps sur le nerf axillaire, dans les paralysies isolées du deltoïde

Cited by 10 publications

References 23 publications

Triceps and cutaneous radial nerve branches investigated via an axillary anterior arm approach: new findings in a fresh-cadaver anatomical study

Triceps and cutaneous radial nerve branches investigated via an axillary anterior arm approach: new findings in a fresh-cadaver anatomical study

Distal nerve transfers for peripheral nerve injuries: indications and outcomes

Triceps motor branch transfer for isolated traumatic pediatric axillary nerve injuries

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