Nerve transfer to biceps muscle using a part of ulnar nerve for C5–C6 avulsion of the brachial plexus: Anatomical study and report of four cases

Oberlin, C.; Beal, David D.; Leechavengvongs, Somsak; Salon, A.; Dauge, Marie-Christine; Sarcy, J.J.

doi:10.1016/0363-5023(94)90011-6

Cited by 701 publications

(487 citation statements)

References 4 publications

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“…have recently been described in the upper extremities to restore movement and function [8,9,11,13,19]. Success of upper extremity nerve transfers has stimulated the potential use of nerve transfers in the lower extremity as a treatment alternative to orthoses or tendon transfer surgery.…”

Section: Discussionmentioning

confidence: 99%

Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

Giuffre

Bishop

Spinner

et al. 2012

Clinical Orthopaedics &Amp; Related Research

106

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Background Injuries to the deep peroneal nerve result in tibialis anterior muscle paralysis and associated loss of ankle dorsiflexion. Nerve grafting of peroneal nerve injuries has led to poor function; therefore, tendon transfers and anklefoot orthotics have been the standard treatment for foot drop. Questions/purposes We (1) describe an alternative surgical technique to obtain ankle dorsiflexion by partial tibial nerve transfer to the motor branch of the tibialis anterior muscle; (2) evaluate ankle dorsiflexion strength using British Medical Research Council grading after nerve transfer; and (3) qualitatively determine factors that influence functional success of surgery. Methods We retrospectively reviewed 11 patients treated with partial tibial nerve transfers after peroneal nerve injury. Pre-and postoperative motor strength was measured. Patients completed questionnaires regarding preand postoperative gait and disability.

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Section: Discussionmentioning

confidence: 99%

Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

Giuffre

Bishop

Spinner

et al. 2012

Clinical Orthopaedics &Amp; Related Research

106

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“…Nerve transfers represented a major advance in the treatment of these lesions. Oberlin et al 4 described the nerve transfer technique where one or more ulnar nerve fascicles are transferred to the musculocutaneous nerve branch for gain of elbow flexion, and later on MacKinnon et al 5 described the double transfer technique, in which besides transferring an ulnar nerve fascicle to the biceps brachii muscle, they transfer a median nerve fascicle to the brachialis muscle. In cases of impossibility of neurological reconstruction, failure in nerve transfers or insufficient return of muscle strength for elbow flexion, the tendon transfers for reestablishment of active elbow flexion are procedures to be indicated.…”

Section: Introductionmentioning

confidence: 99%

“…6 As a rule, we should attempt nerve reconstruction first, and when it does not present a good result or is no longer indicated, we can resort to muscle transfer surgeries, when possible, where the muscles used most often are: latissimus dorsi [7][8] , pectoralis major 9 , triceps 10,11 , flexor-pronator muscles of the forearm 2,12,13 and microsurgical free tissue transfers. 4,14,15 The proximal transfer of the flexor-pronator muscles of the forearm to the medial intermuscular septum of humerus (brachial fascia), was described by Steindler 16 . Bunnell 17 suggested radial fixation to decrease the pronator effect of this transfer.…”

Section: Introductionmentioning

confidence: 99%

Avaliação do ganho funcional do cotovelo com a cirurgia de Steindler na lesão do plexo braquial

et al. 2011

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Objective: To evaluate the gain in strength and range of motion after modified Steindler surgery of the elbow in patients with lesions of the upper trunk of the brachial plexus. Method: From 1998 to 2007, eleven patients with traumatic closed upper trunk lesion of the brachial plexus were studied. All the patients had development of at least 1 year of injury and degree of strength of elbow flexion ranging from M1 to M3. The patients underwent Steindler surgery with at least 6 months of follow-up. Pre-and post-operative assessments were carried out to determine gain in muscle strength, range of motion of the elbow, and DASH scale score. Results: Of the eleven patients studied, nine (82%) achieved a level of strength equal to or greater than M3 (MRC) with good functional recovery. Two (18%) reached strength level M2 (MRC). We observed that the patients had an average postoperative gain in range of motion of the elbow of 43.45 degrees. The average elbow flexion after surgery was 88 degrees. There was an improvement in elbow function, as demonstrated in the DASH Scale, in 81% of the patients studied. Conclusion: Modified Steindler surgery was effective in the treatment of patients with injuries of the upper trunk of the brachial plexus, with statistically significant gains in range of motion. In all the cases studied, there was some degree of gain in strength and range of elbow flexion, the gain being correlated with the initial muscle strength. Level of Evidence: Level II, prospective clinical trial.

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“…These studies comprise only 75 patients overall. 1,5,7,9,10,21,25 The differing results are shown in Table 5. Results of a metaanalysis 21 indicated that the accessory nerve-suprascapular nerve transfer is an effective repair technique; however, the indications for surgery in the various studies differed, and the results were not analyzed or presented uniformly.…”

Section: Nerve Transfermentioning

confidence: 98%

Evaluation of suprascapular nerve neurotization after nerve grafting or transfer in the treatment of brachial plexus traction lesions

Malessy¹,

Ruiter²,

Boer³

et al. 2004

FOC

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Object The aim of this retrospective study was to evaluate the restoration of shoulder function by means of supra-scapular nerve neurotization in adult patients with proximal C-5 and C-6 lesions due to a severe brachial plexus traction injury (BPTI). The primary goal of brachial plexus reconstructive surgery was to restore the biceps muscle function and, secondarily, to reanimate shoulder function. Methods Suprascapular nerve neurotization was performed by grafting the C-5 nerve in 24 patients and by accessory or hypoglossal nerve transfer in 29 patients. Additional neurotization involving the axillary nerve could be performed in 18 patients. Postoperative needle electromyography studies of the supraspinatus, infraspinatus, and deltoid muscles showed signs of reinnervation in most patients; however, active glenohumeral shoulder function recovery was poor. In nine (17%) of 53 patients supraspinatus muscle strength was Medical Research Council (MRC) Grade 3 or 4 and in four (8%) infraspinatus muscle power was Grade 3 or 4. In 18 patients in whom deltoid muscle reinnervation was attempted, MRC Grade 3 or 4 function was demonstrated in two (11%). In the overall group, eight patients (15%) exhibited glenohumeral abduction with a mean of 44 ± 17° (standard deviation [SD]) (median 45°) and four patients (8%) exhibited glenohumeral exorotation with a mean of 48 ± 24° (SD) (median 53°). In only three patients (6%) were both functions regained. Conclusions The reanimation of shoulder function in patients with proximal C-5 and C-6 BPTIs following supra-scapular nerve neurotization is disappointingly low.

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Nerve transfer to biceps muscle using a part of ulnar nerve for C5–C6 avulsion of the brachial plexus: Anatomical study and report of four cases

Cited by 701 publications

References 4 publications

Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

Partial Tibial Nerve Transfer to the Tibialis Anterior Motor Branch to Treat Peroneal Nerve Injury After Knee Trauma

Avaliação do ganho funcional do cotovelo com a cirurgia de Steindler na lesão do plexo braquial

Evaluation of suprascapular nerve neurotization after nerve grafting or transfer in the treatment of brachial plexus traction lesions

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