Phrenic nerve transfer versus intercostal nerve transfer for the repair of brachial plexus root avulsion injuries

doi:10.3969/j.issn.2095-4344.2016.51.009

Abstract

Abstract:

BACKGROUND: Phrenic nerve transfer and intercostal nerve transfer are the accepted surgery strategies for the treatment of brachial plexus root avulsion injuries; however, which surgery is more suitable for the repair remains inconclusive.
OBJECTIVE: To observe the treatment outcomes of brachial plexus root avulsion injuries by transferring the phrenic nerve to the anterior division of the upper trunk of brachial plexus and the intercostal nerve to the musculocutaneous nerve.
METHODS: Twenty patients with brachial plexus root avulsion injuries were included. Among them, 9 were treated with phrenic nerve transfer to the anterior division of the upper trunk of brachial plexus (phrenic nerve transfer group), and 11 were treated with intercostal nerve transfer to the musculocutaneous nerve (intercostal nerve transfer group). Postoperative follow-up ranged from 15 to 36 months. Incision length, blood loss, and operation time were recorded. Muscle strength of the biceps and elbow flexion angle were evaluated. The repair outcome was evaluated by assessing the functional recovery of musculocutaneous nerve according to the criteria issued by the Branch of Hand Surgery of Chinese Medicine Association, and the excellent and good rate was calculated.
RESULTS AND CONCLUSION: The excellent and good rate was 66.7% and 63.6%, respectively, in phrenic nerve transfer group and intercostal nerve transfer group, which is not significantly different between both groups (P > 0.05). Smaller length of operation incision, reduced blood loss, and shorter operation time were found in the phrenic nerve transfer group. Two and three patients in bad recovery were in phrenic nerve transfer and intercostal nerve transfer groups, respectively. These findings suggest that the two kinds of surgery strategies for the repair of brachial plexus root avulsion injuries can obtain good results in the functional recovery of elbow flexion. Phrenic nerve transfer exerts superiorities in operation incision, blood loss and operation time.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Phrenic Nerve, Brachial Plexus, Tissue Engineering

CLC Number:

R318

Abdixbir Abra, Li Ping, Ilhamjan Usman, Exmetjan Yüsup. Phrenic nerve transfer versus intercostal nerve transfer for the repair of brachial plexus root avulsion injuries[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(51): 7660-7665.

Figures/Tables 3

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