Transfer of Triceps Motor Branches of the Radial Nerve to the Axillary Nerve with or without other Nerve Transfers Provides Antigravity Shoulder Abduction in Pediatric Brachial Plexus Injury

McRae, Matthew; Borschel, Gregory H.

doi:10.1007/s11552-012-9398-0

Cited by 20 publications

(10 citation statements)

References 10 publications

(12 reference statements)

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“…We also agree with Al-Meshal and Gilbert 13 who have suggested transfer of the most proximal nerve branch to the lateral head of triceps as the preferred choice for deltoid muscle innervation in comparison to the branch of the long head of triceps as the latter transfer risks compromising elbow extension against resistance. McRae and Borschel 18 reported data on five children who underwent transfer of medial head branch for shoulder abduction. All children were able to actively abduct their shoulders against gravity with no compromise of elbow extension in the postoperative follow-up at 1 year.…”

Section: Discussionmentioning

confidence: 99%

Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study

et al. 2018

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The innervation pattern of triceps is complex and not fully comprehended. Anomalous innervations of triceps have been described by various authors. We have attempted to delineate the nerve supply of the triceps and documented the anomalous innervations of its different heads. The brachial plexus and its major branches (in the region of the axilla and arm) and triceps were dissected in 36 embalmed cadaver upper limbs. Long head received one branch from radial nerve in 31 (86%) specimens. Four (11%) specimens received two branches including one that had dual innervation from the radial and axillary nerves, and one (3%) specimen had exclusive innervation from a branch of the axillary nerve. Medial head received two branches arising from the radial nerve in 34 (94%) specimens. One (3%) specimen received three branches from the radial nerve whereas one (3%) had dual supply from the radial and ulnar nerves. Lateral head received multiple branches exclusively from the radial nerve, ranging from 2 to 5, in all (100%) specimens. Knowledge of the variations in innervation of the triceps would not only help the surgeon to avoid inadvertent injury to any of the nerve branches but also offers new options for nerve and free functional muscle transfers.

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Section: Discussionmentioning

confidence: 99%

Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study

et al. 2018

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“…Of the patients, 65-90 % demonstrate functional recovery with the Oberlin transfer [60][61][62]. There is insignificant data to assess isolated outcomes of triceps branch to axillary nerve transfer in children, as it is more commonly done in conjunction with other nerve transfers [63]. Other nerve transfers have also been developed, but are less commonly used, including intercostal nerve transfer and contralateral C7 nerve root transfer [64][65][66][67].…”

Section: Microsurgical Techniquesmentioning

confidence: 99%

The natural history and management of brachial plexus birth palsy

Buterbaugh

Shah

2016

Curr Rev Musculoskelet Med

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Brachial plexus birth palsy (BPBP) is an upper extremity paralysis that occurs due to traction injury of the brachial plexus during childbirth. Approximately 20 % of children with brachial plexus birth palsy will have residual neurologic deficits. These permanent and significant impacts on upper limb function continue to spur interest in optimizing the management of a problem with a highly variable natural history. BPBP is generally diagnosed on clinical examination and does not typically require cross-sectional imaging. Physical examination is also the best modality to determine candidates for microsurgical reconstruction of the brachial plexus. The key finding on physical examination that determines need for microsurgery is recovery of antigravity elbow flexion by 3-6 months of age. When indicated, both microsurgery and secondary shoulder and elbow procedures are effective and can substantially improve functional outcomes. These procedures include nerve transfers and nerve grafting in infants and secondary procedures in children, such as botulinum toxin injection, shoulder tendon transfers, and humeral derotational osteotomy.

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“…The transfer of triceps motor branches of the radial nerve to the axillary nerve appears to be safe and effective. The functional loss relative to the triceps, with a single nerve transferred, is negligible because of compensation by the remaining heads [22]. Nerve transfers permit faster reinnervation of muscles than nerve grafting because the nerve repair can be performed much closer to the neuromuscular junction.…”

Section: Discussionmentioning

confidence: 99%

Results of nerve reconstructions in treatment of obstetrical brachial plexus injuries

2015

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Transfer of Triceps Motor Branches of the Radial Nerve to the Axillary Nerve with or without other Nerve Transfers Provides Antigravity Shoulder Abduction in Pediatric Brachial Plexus Injury

Cited by 20 publications

References 10 publications

Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study

Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study

The natural history and management of brachial plexus birth palsy

Results of nerve reconstructions in treatment of obstetrical brachial plexus injuries

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