Transfer of a Radial Nerve Branch to the Brachialis Nerve for Restoration of Elbow Flexion

Chepla, Kyle J.; Bafus, Blaine T.

doi:10.1097/bth.0000000000000186

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…The series by Bertelli and Ghizoni (2014) supports the transfer of the anconeus nerve to the anterior division of the axillary nerve as an effective and reliable method of deltoid reinnervation. Recently, Chepla and Bafus (2018) described the use of the anconeus nerve transferred to the brachialis nerve to restore elbow flexion as an alternative to the Oberlin technique. Transfer to the biceps branch (Figure S1) or to the anteriorly transposed ulnar nerve are further possible options.…”

Section: Resultsmentioning

confidence: 99%

The anatomy of the anconeus nerve redefined

Maniglio

Zaidenberg

Martinez

et al. 2021

J Hand Surg Eur Vol

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The anconeus nerve is the longest branch of the radial nerve and suitable as a donor for the neurotization of the axillary nerve. The aim of this study was to map its topographical course with reference to palpable, anatomical landmarks. The anconeus nerve was followed in 15 cadaveric specimens from its origin to its entry to the anconeus. It runs between the lateral and the medial head of the triceps before entering the medial head and running intramuscularly further distal. Exiting the muscle, it lies on the periosteum and the articular capsule of the elbow, before entering the anconeus muscle. Two types of anconeus nerve in relation to branches innervating triceps were found: nine nerves also innervated the lateral triceps head, while the other six only contributed two branches to its innervation. The course of the anconeus nerve is important for harvesting as a donor nerve and to protect the nerve in surgical elbow approaches.

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Section: Resultsmentioning

confidence: 99%

The anatomy of the anconeus nerve redefined

Maniglio

Zaidenberg

Martinez

et al. 2021

J Hand Surg Eur Vol

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“…In general, nerve transfers recover relatively quickly compared to nerve grafts, which is reported to be one of the most important factors in the number of viable motor axons 1,10,12) . This technique allows the transfer of regenerating motor axons very close to the neuromuscular junction of the elbow flexors, minimizing the distance and time required for the regenerating front to reach the target muscle 2,[10][11][12]14) . Therefore, patients with prolonged onset of disease can also be candidates for this procedure.…”

Section: Discussionmentioning

confidence: 99%

Double Fascicular Nerve Transfer to Restore Elbow Flexion Following Neuralgic Amyotrophy: A Case Report

Chung

Yang

Cho

et al. 2022

Nerve

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Double fascicular nerve transfer (DFNT) involves transferring fascicles from the median and ulnar nerves to the musculocutaneous nerve to restore elbow flexion. We performed this procedure on a patient who was diagnosed with neuralgic amyotrophy (NA) 2 years previously. We aimed to investigate the short-term outcomes and feasibility of DFNT applied to non-traumatic neuropathy. A 63-year-old, right-handed man presented to us with persistent right elbow flexion weakness 24 months after receiving the diagnosis of NA. On examination, biceps strength was 0/5, and shoulder abduction strength was 3/5. Magnetic resonance neurography demonstrated muscle atrophy in the upper trunk. DFNT was considered to restore elbow flexion. The donor and recipient fascicles were then coapted (flexor digitorum superficialis to biceps brachii, flexor carpi ulnaris to brachialis). Postoperatively, paresthesia was reported in the area of ulnar innervation, and the patient complained of hand clumsiness. From postoperative day 10 onward, biceps muscle contracture was identified and on the 14th day, grade 3 elbow flexion strength was observed. We suggest that DFNT may be a safe and effective method to restore elbow flexion in patients with NA.

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“…The muscle unit along with its innervation may be transferred to reestablish the flexion of elbow (19). Nerve transfer procedures performed for the brachial plexus reconstruction and peripheral nerve injuries have given better outcomes than the nerve grafting (20). Literature search revealed that there are only a very few studies available about the UCN.…”

Section: Introductionmentioning

confidence: 99%

An Anatomical Perspective of Ulnar Collateral Nerve with Reference to Nerve and Muscle Transfer Surgery

Jiji

Joy

Murlimanju

et al. 2020

Muscle Ligaments and Tendons J

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Background. The purpose was to analyze the prevalence, origin, course and termination of the ulnar collateral nerve in anatomical samples from Indian population. Methods. The present study included 68 adult human cadaveric embalmed upper limbs. The sex of these upper limbs were not known. The initial segment of radial nerve was meticulously dissected in the specimens to observe the ulnar collateral nerve. The digital Vernier caliper was used for the measurements which were performed in this study. The data was given in millimeter and expressed as mean ± SD. Results. The ulnar collateral nerve was observed in 57 (83.8%) of our specimens. It originated in the axilla in 35 cases (61.4%), at the brachio-axillary angle in 13 (22.8%) and in the arm in 9 cases (15.8%) respectively. The termination of ulnar collateral nerve by piercing deep into the triceps muscle happened 101.9 ± 4 mm above the medial epicondyle of humerus. The origins of muscular branch to long head of triceps muscle and ulnar collateral nerve were located 44.7 ± 3.7 mm and 66.7 ± 4.4 mm away from the bifurcation of posterior cord respectively. Conclusions. The present study suggests higher frequency of ulnar collateral nerve in sample Indian population. Ulnar collateral nerve can be used to re-innervate the muscles in case of brachial plexus injuries. Our study provides information about the detailed morphology and topography of the ulnar collateral nerve. The detailed knowledge can help the orthopedic surgeons during the procedures like muscle transfer, nerve transfer and nerve grafting.

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Transfer of a Radial Nerve Branch to the Brachialis Nerve for Restoration of Elbow Flexion

Cited by 5 publications

References 8 publications

The anatomy of the anconeus nerve redefined

The anatomy of the anconeus nerve redefined

Double Fascicular Nerve Transfer to Restore Elbow Flexion Following Neuralgic Amyotrophy: A Case Report

An Anatomical Perspective of Ulnar Collateral Nerve with Reference to Nerve and Muscle Transfer Surgery

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