Medial pectoral nerve transfer

Park, Tae Sung

doi:10.3171/2008.12.peds08370

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…19,34 As an intraplexus source, the medial pectoral nerve acts as a guaranteed donor for patients with C5/C6 injury because it receives output mainly from C8/T1. However, the use of the medial pectoral nerve as a donor nerve remains controversial 19,35 because of the limitations in length and the potential loss of shoulder internal rotation. Considering the limitations and doubt in the use of intraplexus donor nerve, we switched to using intercostal nerves for transfer to the axillary nerve.…”

Section: Discussionmentioning

confidence: 99%

Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury

Chu¹,

Wang²,

Chen³

et al. 2016

Annals of Plastic Surgery

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The purpose of this study was to investigate the effectiveness of shoulder function restoration by dual nerve transfers, spinal accessory nerve to the suprascapular nerve and 2 intercostal nerves to the anterior branch of the axillary nerve, in patients with shoulder paralysis that resulted from brachial plexus avulsion injury. It was a retrospective analysis to assess the impact of a variety of factors on reanimation of shoulder functions with dual nerve transfers. A total of 19 patients were included in this study. Most of these patients sustained avulsions of C5, C6, and C7 nerve roots (16 patients). Three of them had avulsions of C5 and C6 roots only. Through a posterior approach, direct coaptation of the intercostal nerves and the anterior branch of the axillary nerve was performed, along with accessory nerve transfer to the suprascapular nerve. Satisfactory shoulder function recovery (93.83° of shoulder abduction and 54.00° of external rotation on average) was achieved after a 62-month follow-up. This dual nerve transfer procedure provided us with a reliable and effective method for shoulder function reconstruction after brachial plexus root avulsion, especially C5/C6/C7 avulsion. The level of evidence is therapeutic IV.

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Section: Discussionmentioning

confidence: 99%

Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury

Chu¹,

Wang²,

Chen³

et al. 2016

Annals of Plastic Surgery

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“…With regard to the partial or total loss of pectoralis muscles function, the subscapularis and latissimus dorsi are usually considered to provide sufficient strength for internal rotation and adduction (Aszmann et al,2000). Some authors have suggested the use of intraoperative electrical stimulation to identify the MPN or proximal and distal stumps of the severed donor nerve (Kline,2000; McGillicuddy,2001; Blaauw and Slooff,2003; Park,2009). Conversely, many authors suggest that muscle reinnervation through neurotization has to be preferred to muscle transfer bothfor functional and biomechanical superiority (Steindler,1983; Aszmann et al,2000).…”

Section: Motor Innervationmentioning

confidence: 99%

Surgical anatomy of the pectoral nerves and the pectoral musculature

et al. 2011

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The pectoral nerves (PNs) may be selectively injured through various traumatic mechanisms such as direct trauma, hypertrophic muscle compression, and iatrogenic injuries (breast surgery and axillary node dissection, pectoralis major muscle transfers). The PN may be surgically recovered through nerve transfers. They may also be used as donors to the musculocutaneous, axillary, long thoracic, and spinal accessory nerves and for reinnervation of myocutaneous free flaps. Thus, in this article, we reviewed the surgical anatomy of PN. A meta-analysis of the available literature showed that the lateral pectoral nerve (LPN) arises most frequently with two branches from the anterior divisions of the upper and middle trunks (33.8%) or as a single root from the lateral cord (23.4%). The medial pectoral nerve (MPN) usually arises from the medial cord (49.3%), anterior division of the lower trunk (43.8%), or lower trunk (4.7%). The two PN are usually connected immediately distal to the thoracoacromial artery by the so-called ansa pectoralis. The MPN may also show communications with the intercostobrachial nerve. In 50%-100% of cases, it may pass, at least with some branches, through the pectoralis minor muscle. The LPN supplies the upper portions of the pectoralis major muscle; the MPN innervates the lower parts of the pectoralis major and the pectoralis minor muscle. Among the accessory muscles of the pectoral girdle, the LPN may also innervate the tensor semivaginae articulationis humero-scapularis, pectoralis minimus, sternoclavicularis, axillary arch, sternalis, and infraclavicularis muscles; the MPN may innervate the pectoralis quartus, chondrofascialis, axillary arch, chondroepitrochlearis, and sternalis muscles.

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“…Other utilized nerves include the intercostals, thoracodorsal nerve, long thoracic nerve, phrenic nerve, distal accessory nerve, ipsilateral C7 root, contra lateral C7 root, and the suprascapular nerve [2,3,4]. Although well described in the literature, the utility of the MPN as a donor nerve remains controversial [5,6,7] due to the limitations in length, inappropriate diameter match, and potential loss of shoulder internal rotation.…”

Section: Discussionmentioning

confidence: 99%