Nerve transfers to the biceps and brachialis branches to improve elbow flexion strength after brachial plexus injuries

Tung, Thomas H.; Novak, Christine B.; Mackinnon, Susan E.

doi:10.3171/jns.2003.98.2.0313

Cited by 162 publications

(86 citation statements)

References 20 publications

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“…This provided the impetus for the senior author_s (S.E.M.) development of a double fascicular transfer from both the median and the ulnar nerves to musculocutaneous branches to both the biceps and the brachialis, which provides better recovery of elbow flexion strength than reinnervation of the biceps muscle alone [15,22]. Similarly, for reconstruction of the axillary nerve, transfers that reinnervate the teres minor in addition to the deltoid would be expected to provide better shoulder function, particularly with regard to external rotation and glenohumeral stability, than those that exclude the branch to teres minor.…”

Section: Discussionmentioning

confidence: 99%

Posterior Approach for Double Nerve Transfer for Restoration of Shoulder Function in Upper Brachial Plexus Palsy

Colbert

Mackinnon²

2006

Hand (New York, N,Y.)

121

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Restoration of shoulder function is one of the most critical goals of treatment of brachial plexus injuries. Primary repair or nerve grafting of avulsion injuries of the upper brachial plexus in adults often leads to poor recovery. Nerve transfers have provided an alternative treatment with great potential for improved return of function. Many different nerves have been utilized as donor nerves for transfer to the suprascapular nerve and axillary nerve for return of shoulder function with variable results. As our knowledge of shoulder neuromuscular anatomy and physiology improves and our experience with nerve transfers increases, so evolve the specific transfer procedures. This article presents a technique and rationale for reconstructing shoulder function by transferring the distal spinal accessory nerve to the suprascapular nerve and the nerve branch to the medial head of the triceps to the axillary nerve, both through a posterior approach.

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Section: Discussionmentioning

confidence: 99%

Posterior Approach for Double Nerve Transfer for Restoration of Shoulder Function in Upper Brachial Plexus Palsy

Colbert

Mackinnon²

2006

Hand (New York, N,Y.)

121

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“…[17][18][19][21][22][23]25,[37][38][39][40][41][42]). Nerve transfers can be directed to the biceps muscle or the brachialis muscle.…”

Section: Nerve Transfers For Elbow Motionmentioning

confidence: 98%

“…The principles of nerve transfer are remarkably similar to those of tendon transfer [22]. The proper selection of a donor and recipient nerve requires a clear understanding of the principles.…”

Section: Principles Of Nerve Transfermentioning

confidence: 99%

“…The brachialis muscle is the primary elbow flexor; the biceps muscle is a primary forearm supinator and secondarily provides elbow flexion. Therefore, reinnervation of the brachialis muscle and the biceps muscle makes sense, with an additional advantage of improving elbow flexion strength [22,38].…”

Section: Nerve Transfers For Elbow Motionmentioning

confidence: 99%

“…Nerve transfers can be directed toward the suprascapular nerve or the axillary nerve [17,18,22,[24][25][26][27][28][29][30][31][32][33]. In the flail shoulder, the author prefers to perform both nerve transfers to maximize shoulder motion.…”

Section: Nerve Transfers For Shoulder Motionmentioning

confidence: 99%

See 2 more Smart Citations

Nerve Transfers in Brachial Plexus Birth Palsies: Indications, Techniques, and Outcomes

Kozin

2008

Hand Clinics

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Surgical anatomy of the radial nerve branches to triceps muscle

et al. 2012

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The objectives of the study are to demonstrate the innervation patterns of the triceps muscles and the most suitable branch of the radial nerve for nerve transfer to restore the motor function of the deltoid muscle in patients with complete C5-C6 root injury. Seventy-nine arms (40 left arms and 39 right arms) from 46 embalmed cadavers (24 male and 22 female) were included in the study. The nerves to the triceps were dissected from the triceps muscles (long head, lateral head, and medial head). The lengths of the branches were measured from the main trunk. The distance from the inferior margin of the teres major muscle to the origin of the nerve to the long head, lateral head, and medial head of the triceps were recorded as well. The first branch was the nerve to the long head of the triceps in 79 arms (100%). The second branch was the nerve to the upper medial head in 30 arms (38%), nerve to the medial head in 8 arms (10.1%), nerve to the upper lateral head in 35 arms (44.3%) and nerve to the lateral head in 6 arms (7.6%). The patterns of branches to the triceps were classified according to our dissections. The nerve to the long head of the triceps was constant as the first branch of the nerve to the triceps branch of the radial nerve in the vicinity of the inferior margin of the teres major muscle.

show abstract

Nerve transfers to the biceps and brachialis branches to improve elbow flexion strength after brachial plexus injuries

Abstract: The use of nerve transfers to reinnervate the biceps and brachialis muscle provides excellent elbow flexion strength in patients with brachial plexus nerve injuries.

Cited by 162 publications

References 20 publications

Posterior Approach for Double Nerve Transfer for Restoration of Shoulder Function in Upper Brachial Plexus Palsy

Posterior Approach for Double Nerve Transfer for Restoration of Shoulder Function in Upper Brachial Plexus Palsy

Nerve Transfers in Brachial Plexus Birth Palsies: Indications, Techniques, and Outcomes

Surgical anatomy of the radial nerve branches to triceps muscle

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