Transfer of the Medial Pectoral Nerve: Myth or Reality?

Abstract

Our surgical results suggest that the transfer of the medial pectoral nerve to the musculocutaneous nerve and also to the axillary nerve may be a reliable and effective procedure.

Simultaneous Intercostal Nerve Transfers to Deltoid and Triceps Muscle Through the Posterior Approach

“…9 We graded shoulder function using the system described by Samardzic et al 10,11 To evaluate shoulder abduction, the patients were asked to abduct and externally rotate their shoulders. We recorded muscle strength and the degree of shoulder abduction and external rotation.…”

Transfer of Pectoral Nerves to Suprascapular and Axillary Nerves: An Anatomic Feasibility Study

“…As reported in prior clinical studies, we found that the pectoral nerves reached the axillary nerve without nerve graft and without cutting the ansa pectoralis in all cases. 13,18 However, when 1 branch of the pectoral nerves is transferred to the axillary nerve, a diameter disparity should be expected. An adequate length of the middle and the inferior branches was found to reach the suprascapular nerve without nerve grafting and without cutting the ansa pectoralis.…”

“…13,18 Samardzic reported that useful functional recovery was achieved in 9 of 11 patients who had medial pectoral nerve transfer to the axillary nerve. 18 Moreover, Stockinger obtained M4 shoulder abduction by transferring a medial pectoral nerve to an axillary nerve in 1 patient. 13 The pectoral nerves are intraplexal, voluntary motor nerves with a high number of motor fibers.…”

“…12,13 Based on Samardzic, we think that partial loss of pectoralis function can be as consequential as the iatrogenic trapezius paresis provided by the spinal accessory nerve in shoulder reanimation. 18 One weakness of this anatomic feasibility study is that the extensive dissection of the cadaver is not precisely what will be found during surgery and the transfer to the suprascapular nerve will not be easy on overweight patients.…”

Microsurgery of the Upper Extremity

“…82,83 Acceptable results can also be obtained with transfers of the thoracodorsal nerve 84,85 and branches of the medial pectoral nerve. 86,87 Shoulder results have not had the same success, even though the suprascapular and axillary nerves are reinnervated simultaneously. 88 Donor branches are traditionally harvested from the triceps muscle and the accessory nerve.…”