Transfer of Pectoral Nerves to the Musculocutaneous Nerve in Obstetric Upper Brachial Plexus Palsy

Author:

Blaauw Gerhard1,Slooff Albert C.J.1

Affiliation:

1. Department of Neurosurgery, University Hospital Maastricht, Maastricht, and Department of Neurosurgery, Atrium Medical Center, Heerlen, The Netherlands

Abstract

Abstract OBJECTIVE To investigate the results of transfer of pectoral nerves to the musculocutaneous nerve for treatment of obstetric brachial palsy. METHODS In 25 cases of obstetric brachial palsy (20 after breech deliveries), branches of the pectoral nerve plexus were transferred directly to the musculocutaneous nerve. For all patients, the nerve transfer was part of an extended brachial plexus reconstruction. Results were tested both clinically and with the Mallet scale, at a mean follow-up time of 70 months (standard deviation, 34.3 mo). RESULTS There were two complete failures, which were attributable to disconnection of the transferred nerve endings. The results after transfer were excellent in 17 cases and fair in 5 cases. Steindler flexorplasty improved elbow flexion for three patients. CONCLUSION Transfer of pectoral nerves to the musculocutaneous nerve for treatment of obstetric upper brachial palsy may be effective, if the specific anatomic features of the pectoral nerve plexus are sufficiently appreciated.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Surgery

Reference20 articles.

1. The anatomy of the pectoral nerves and their significance in brachial plexus reconstruction;Aszmann;J Hand Surg [Am],2000

2. A technique for maximizing biceps recovery in brachial plexus reconstruction;Brandt;J Hand Surg [Am],1993

3. Die Kriegsschädigungen der peripheren Nerven;Foerster

4. Obstetrical brachial plexus palsy;Gilbert,1993

5. Surgical relationship of the medial pectoral nerve to the musculocutaneous nerve: A cadaveric study;Hansasuta;Neurosurgery,2001

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