Original CommunicationsResults of nerve transfer techniques for restoration of shoulder and elbow function in the context of a meta-analysis of the English literature☆,☆☆
Section snippets
Case series
Between October 1991 and November 1999 we performed surgical exploration and repair on 35 patients (age range, 4 months to 67 years) with brachial plexus injuries. Of these, 29 had nerve transfers. Fifteen patients with nerve transfers met the inclusion criteria for the study, which included surgery within 12 months of injury and a minimum follow-up period of 1 year. All 15 patients were male. Perinatal brachial plexus palsies were excluded from the analysis. The dominant extremity was involved
Case series
In the series of patients from our institution we achieved restoration of ≥M3 bicep strength in 9 of the 10 intercostal to musculocutaneous nerve transfers. Seven of the 10 patients achieved M4 biceps recovery. One medial pectoral nerve to musculocutaneous nerve transfer was performed that obtained M3 biceps strength (Table 3).
For restoration of shoulder abduction 3 of 6 patients who underwent spinal accessory to suprascapular nerve transfer achieved ≥M3 shoulder abduction and 2 of these
Discussion
The functional outcomes of our 15 patients who underwent nerve transfer for restoration of shoulder and elbow function mirror the results of the English literature and provide additional support for this reconstruction option in these severely injured patients. The results of the meta-analysis suggest that there is a disadvantage to using interposition nerve grafts when performing intercostal nerve transfers for restoration of biceps function. There are some theoretical advantages to
Acknowledgements
The authors thank Alain C.J. Delotbiniere, MD, for the inclusion of his patients in this series.
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No benefits in any form have been received or will be received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Reprint requests: Scott W. Wolfe, MD, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021.