Thoracodorsal nerve transfer for elbow flexion reconstruction in infraclavicular brachial plexus injuries. 2014

Francisco Soldado, and Marcos F Ghizoni, and Jayme Bertelli
Department of Pediatric Upper Extremity Surgery and Microsurgery, Hospital Sant Joan de Deu, Universitat de Barcelona, Barcelona, Spain; Department of Neurosurgery, Center of Biological and Health Sciences, University of the South of Santa Catarina (Unisul), Tubarão, Brazil; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, Santa Catarina, Brazil. Electronic address: drsoldado@cirugiamanoinfantil.com.

OBJECTIVE To report the clinical results of thoracodorsal nerve (TDN) transfer to the biceps nerve for elbow flexion restoration in infraclavicular brachial plexus injuries. METHODS Five male patients, mean age 33 years and affected with infraclavicular brachial plexus injuries, underwent a direct coaptation of the TDN to the nerve to the biceps an average of 8 months after injury. The procedure included the transfer of a branch of the TDN to the musculocutaneous nerve in 2 patients. RESULTS All patients achieved M4 elbow flexion strength according to the British Medical Research Council scale at a mean follow-up of 22 months. CONCLUSIONS Direct TDN transfer seems to be a useful surgical procedure for restoring elbow flexion in patients with infraclavicular brachial plexus injuries. METHODS Therapeutic IV.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001917 Brachial Plexus The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. Plexus, Brachial
D004550 Elbow Region of the body immediately surrounding and including the ELBOW JOINT.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001132 Arm The superior part of the upper extremity between the SHOULDER and the ELBOW. Brachium,Upper Arm,Arm, Upper,Arms,Arms, Upper,Brachiums,Upper Arms
D016067 Nerve Transfer Surgical reinnervation of a denervated peripheral target using a healthy donor nerve and/or its proximal stump. The direct connection is usually made to a healthy postlesional distal portion of a non-functioning nerve or implanted directly into denervated muscle or insensitive skin. Nerve sprouts will grow from the transferred nerve into the denervated elements and establish contact between them and the neurons that formerly controlled another area. Nerve Crossover,Neurotization,Crossover, Nerve,Crossovers, Nerve,Nerve Crossovers,Nerve Transfers,Neurotizations,Transfer, Nerve,Transfers, Nerve
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D020516 Brachial Plexus Neuropathies Diseases of the cervical (and first thoracic) roots, nerve trunks, cords, and peripheral nerve components of the BRACHIAL PLEXUS. Clinical manifestations include regional pain, PARESTHESIA; MUSCLE WEAKNESS, and decreased sensation (HYPESTHESIA) in the upper extremity. These disorders may be associated with trauma (including BIRTH INJURIES); THORACIC OUTLET SYNDROME; NEOPLASMS; NEURITIS; RADIOTHERAPY; and other conditions. (From Adams et al., Principles of Neurology, 6th ed, pp1351-2) Brachial Plexopathy,Erb Paralysis,Klumpke Paralysis,Brachial Plexus Diseases,Brachial Plexus Disorders,Dejerine-Klumpke Palsy,Erb's Palsy,Erb-Duchenne Paralysis,Klumpke's Palsy,Lower Brachial Plexus Neuropathy,Lower Brachial Plexus Palsy,Middle Brachial Plexus Neuropathy,Paralysis of the Lower Brachial Plexus,Upper Brachial Plexus Neuropathy,Brachial Plexus Disease,Brachial Plexus Disorder,Brachial Plexus Neuropathy,Dejerine Klumpke Palsy,Erb Duchenne Paralysis,Erb Palsy,Erb Paralyses,Erb's Palsies,Erb-Duchenne Paralyses,Erbs Palsy,Klumpke Palsy,Klumpkes Palsy,Neuropathies, Brachial Plexus,Neuropathy, Brachial Plexus,Palsies, Erb's,Palsy, Dejerine-Klumpke,Palsy, Erb's,Palsy, Klumpke's,Paralyses, Erb,Paralyses, Erb-Duchenne,Paralysis, Erb,Paralysis, Erb-Duchenne,Paralysis, Klumpke,Plexopathies, Brachial,Plexopathy, Brachial,Plexus Disease, Brachial,Plexus Diseases, Brachial,Plexus Disorder, Brachial,Plexus Disorders, Brachial,Plexus Neuropathies, Brachial,Plexus Neuropathy, Brachial

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