Surgical treatment for total root avulsion type brachial plexus injuries by neurotization: A prospective comparison study between total and hemicontralateral C7 nerve root transfer

Yuan Kun Tu, Yi Jung Tsai, Chih Han Chang, Fong Chin Su, Chih Kun Hsiao, Jacqueline Siau Woon Tan

Research output: Contribution to journalReview articlepeer-review

37 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)91-101
Number of pages11
JournalMicrosurgery
Volume34
Issue number2
DOIs
Publication statusPublished - 2014 Feb

All Science Journal Classification (ASJC) codes

  • Surgery

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