TY - JOUR
T1 - Surgical treatment for total root avulsion type brachial plexus injuries by neurotization
T2 - A prospective comparison study between total and hemicontralateral C7 nerve root transfer
AU - Tu, Yuan Kun
AU - Tsai, Yi Jung
AU - Chang, Chih Han
AU - Su, Fong Chin
AU - Hsiao, Chih Kun
AU - Tan, Jacqueline Siau Woon
PY - 2014/2
Y1 - 2014/2
N2 - Purpose: We conducted a clinical study to evaluate the effects of neurotization, especially comparing the total contralateral C7 (CC7) root transfer to hemi-CC7 transfer, on total root avulsion brachial plexus injuries (BPI). Methods: Forty patients who received neurotization for BPI were enrolled in this prospective study. Group 1 (n = 20) received hemi-CC7 transfer for hand function, while group 2 (n = 20) received total-CC7 transfer. Additional neurotization included spinal accessory, phrenic, and intercostal nerve transfer for shoulder and elbow function. The results were evaluated with an average of 6 years follow-up. Results: Group 1 had fewer donor site complications (15%) than group 2 (45%); group 2 had significantly better hand M3 and M4 motor function (65%) than group 1 (30%; P = 0.02). There was no difference in sensory recovery. Significantly, better shoulder function was obtained by simultaneous neurotization on both suprascapular and axillary nerves. Conclusions: Total-CC7 transfer had better hand recovery but more donor complications than hemi-CC7. Neurotization on both supra-scapular and axillary nerves improved shoulder recovery. © 2013 Wiley Periodicals, Inc. Microsurgery 34:91-101, 2014.
AB - Purpose: We conducted a clinical study to evaluate the effects of neurotization, especially comparing the total contralateral C7 (CC7) root transfer to hemi-CC7 transfer, on total root avulsion brachial plexus injuries (BPI). Methods: Forty patients who received neurotization for BPI were enrolled in this prospective study. Group 1 (n = 20) received hemi-CC7 transfer for hand function, while group 2 (n = 20) received total-CC7 transfer. Additional neurotization included spinal accessory, phrenic, and intercostal nerve transfer for shoulder and elbow function. The results were evaluated with an average of 6 years follow-up. Results: Group 1 had fewer donor site complications (15%) than group 2 (45%); group 2 had significantly better hand M3 and M4 motor function (65%) than group 1 (30%; P = 0.02). There was no difference in sensory recovery. Significantly, better shoulder function was obtained by simultaneous neurotization on both suprascapular and axillary nerves. Conclusions: Total-CC7 transfer had better hand recovery but more donor complications than hemi-CC7. Neurotization on both supra-scapular and axillary nerves improved shoulder recovery. © 2013 Wiley Periodicals, Inc. Microsurgery 34:91-101, 2014.
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U2 - 10.1002/micr.22148
DO - 10.1002/micr.22148
M3 - Review article
C2 - 23913440
AN - SCOPUS:84893868019
VL - 34
SP - 91
EP - 101
JO - International Journal of Microsurgery
JF - International Journal of Microsurgery
SN - 0738-1085
IS - 2
ER -