Results of Nerve Transfers to the Musculocutaneous and Axillary Nerves

Samardžić, Miroslav; Rasulić, Lukas; Grujičić, Danica; Miličić, Biljana

doi:10.1093/neurosurgery/46.1.93

Cited by 70 publications

(25 citation statements)

References 22 publications

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“…Samardzic et al case series achieving 63.2% recovery of axillary nerve function. 44 Reports suggest that taking 3 or 4 intercostal nerves is an accepted practice with good results. 13,26,33,44 If the spinal accessory nerve is used for axillary nerve neurotization, although the trapezius is synergistic to deltoid function, an interposition graft is required due to distance.…”

Section: Discussionmentioning

confidence: 99%

“…44 Reports suggest that taking 3 or 4 intercostal nerves is an accepted practice with good results. 13,26,33,44 If the spinal accessory nerve is used for axillary nerve neurotization, although the trapezius is synergistic to deltoid function, an interposition graft is required due to distance. 5 The thoracodorsal nerve, responsible for shoulder adduction, has also been used, but deltoid contraction was seen during shoulder adduction, which defeats the purpose of restoring shoulder abduction.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series

Zuckerman¹,

Eli²,

Shah

et al. 2014

PED

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Object Axillary nerve palsy, isolated or as part of a more complex brachial plexus injury, can have profound effects on upper-extremity function. Radial to axillary nerve neurotization is a useful technique for regaining shoulder abduction with little compromise of other neurological function. A combined experience of this procedure used in children is reviewed. Methods A retrospective review of the authors' experience across 3 tertiary care centers with brachial plexus and peripheral nerve injury in children (younger than 18 years) revealed 7 cases involving patients with axillary nerve injury as part of an overall brachial plexus injury with persistent shoulder abduction deficits. Two surgical approaches to the region were used. Results Four infants (ages 0.6, 0.8, 0.8, and 0.6 years) and 3 older children (ages 8, 15, and 17 years) underwent surgical intervention. No patient had significant shoulder abduction past 15° preoperatively. In 3 cases, additional neurotization was performed in conjunction with the procedure of interest. Two surgical approaches were used: posterior and transaxillary. All patients displayed improvement in shoulder abduction. All were able to activate their deltoid muscle to raise their arm against gravity and 4 of 7 were able to abduct against resistance. The median duration of follow-up was 15 months (range 8 months to 5.9 years). Conclusions Radial to axillary nerve neurotization improved shoulder abduction in this series of patients treated at 3 institutions. While rarely used in children, this neurotization procedure is an excellent option to restore deltoid function in children with brachial plexus injury due to birth or accidental trauma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series

Zuckerman¹,

Eli²,

Shah

et al. 2014

PED

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“…La transferencia del nervio accesorio del espinal puede generar secuelas graves, puesto que el músculo trapecio podría ser uno de los pocos músculos útiles tras una lesión panplexual. Sin embargo, la transferencia del nervio accesorio del espinal se realiza utilizando la porción distal del nervio, de forma que la parte central del trapecio se conserva y la parte proximal del mismo tiene una inervación mixta con ramas del plexo cervical (26).…”

Section: Discussionunclassified

Estudio anatómico de la transferencia de los nervios accesorio y toracodorsal al nervio cubital en el gato

Martínez-Méndez

Guerrero

Conde

et al. 2008

Cir. plást. iberolatinoam.

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Palabras clave Estudio experimental. Lesiones del plexo braquial. Transferencia nerviosa.Código numérico 15821-3104-3220 Las lesiones del plexo braquial son una de las patologías más graves y con mayor número de secuelas del miembro superior. En el momento actual las transferencias nerviosas se encuentran en primera línea del armamento terapéutico para reconstruir funciones proximales del miembro superior. En el estudio que presentamos se realizaron 20 transferencias nerviosas al nervio cubital del gato común, tomando bien el nervio accesorio del espinal (10 casos) o bien el nervio toracodorsal (10 casos). Como grupo control se utilizó el lado contralateral al intervenido. Durante el año siguiente, se evaluó la reinervación mediante estudios electromiográficos, histológicos de nervio y músculo, así como histoquímicos de médula espinal. Tras el análisis de los resultados encontramos que las motoneuronas de ambos nervios donantes son capaces de conseguir reinervaciones parciales del territorio cubital. A brachial plexus injury is one of the most severe pathologies of the upper limb, and also has severe sequels. In the actual state of the art, nerve transfers are being used as first line of therapeutic approach in the reconstruction of proximal functions of the upper limb. In this study 20 nerve transfers were made to the ulnar nerve of the cat, using the spinal accessory nerve (10 cases) or the thoracodorsal nerve (10 cases). The opposite side was used as control. During next year, reinnervation was assessed by electromyography, nerve and muscle histology and histochemical evaluation of the spinal cord. We found that motoneurons of both donor nerves are able to make partial reinervation of the ulnar nerve territory.Martínez-Méndez, J.R.

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“…La utilización de fascículos del nervio cubital para transferirlos al musculocutáneo ha demostrado ser una técnica eficaz y es la más extendida en la actualidad para la reinervación del bíceps. Un inconveniente de esta téc-nica es que existe el riesgo potencial de que la sección de los fascículos destinados al flexor carpi ulnaris produzca una debilidad tal en este músculo que no permita, en un segundo tiempo, realizar una transposición muscular del grupo pronato/flexor para aumentar la fuerza para la flexión del codo o una transferencia tendinosa del flexor carpi ulnaris para recuperar la extensión de la muñeca y los dedos 2,18,29,30,32,35,38 . De hecho, Bertelli y Ghizoni, preservan siempre el fascículo para el flexor carpi ulnaris para evitar el riesgo de denervar al músculo en vistas a futuras transposiciones complementarias.…”

Section: Neurotización Con El Nervio Cubitalunclassified

“…Las transferencias intraplexuales más empleadas en la actualidad son la del fascículo extrínseco del nervio cubital (llamada técnica de Oberlin I), los fascículos cubital y mediano asociados (llamada técnica de Oberlin II), el ramo motor a la cabeza larga del tríceps, ramo a su vez del nervio radial, la raíz C7 ipsilateral, el nervio pectoral medial, y el fascículo motor extrínseco del nervio mediano. En este trabajo de revisión se describen estas técnicas además de otras menos frecuentemente utilizadas, así como sus indicaciones y resultados, fruto de un análisis exhaustivo de los trabajos publicados en la literatura en lengua inglesa durante las dos últimas décadas 1,5,10,13,14,17,19,22,30,32,33,36,38 .…”

Section: Introductionunclassified

Técnicas de reconstrucción nerviosa en cirugía del plexo braquial traumatizado (Parte 2): Transferencias nerviosas intraplexuales

Robla-Costales¹,

Socolovsky²,

Masi³

et al. 2011

Neurocirugía

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Results of Nerve Transfers to the Musculocutaneous and Axillary Nerves

Abstract: Our findings suggest that nerve transfer of collateral branches when possible, such as in cases involving upper brachial plexus palsy, may be the method of choice, yielding better results.

Cited by 70 publications

References 22 publications

Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series

Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series

Estudio anatómico de la transferencia de los nervios accesorio y toracodorsal al nervio cubital en el gato

Técnicas de reconstrucción nerviosa en cirugía del plexo braquial traumatizado (Parte 2): Transferencias nerviosas intraplexuales

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