Article

Full-length phrenic nerve transfer as the treatment for brachial plexus avulsion injury to restore wrist and finger extension.

Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai 200003, PR China.
Muscle & Nerve (impact factor: 2.37). 01/2012; 45(1):39-42. DOI:10.1002/mus.22161 pp.39-42
Source: PubMed

ABSTRACT The functional restoration of wrist and finger extension after complete brachial plexus avulsion injury remains an unsolved problem. We conducted a prospective study to elucidate a new method for resolving this injury.
Six patients with complete brachial plexus avulsion injury underwent a new surgical procedure in which the full-length phrenic nerve was transferred to the medial portion of the radial nerve at the level of the latissimus dorsi insertion via endoscopic thoracic surgery.
In 5 patients, extensor carpi ulnaris and extensor carpi radialis strength recovered to Medical Research Council grade ≥M3, and in 4 patients extensor digitorum strength recovered to ≥M3.
Neurotization of phrenic nerve to the medial portion of the radial nerve at the level of latissimus dorsi insertion is a feasible means of restoring wrist and finger extension in cases of complete brachial plexus avulsion injury.

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Keywords

4 patients extensor digitorum strength
 
complete brachial plexus avulsion injury
 
elucidate
 
endoscopic thoracic surgery
 
extensor carpi radialis strength
 
extensor carpi ulnaris
 
finger extension
 
full-length phrenic nerve
 
functional restoration
 
latissimus dorsi insertion
 
medial portion
 
Medical Research Council grade ≥M3
 
new surgical procedure
 
phrenic nerve
 
prospective study
 
radial nerve
 
unsolved problem
 

Haodong Lin