Get access

Full-length phrenic nerve transfer as the treatment for brachial plexus avulsion injury to restore wrist and finger extension

Authors

  • Haodong Lin MD, PhD,

    1. Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai 200003, PR China
    Search for more papers by this author
  • Chunlin Hou MD,

    Corresponding author
    1. Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai 200003, PR China
    • Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai 200003, PR China
    Search for more papers by this author
  • Desong Chen MD

    1. Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai 200003, PR China
    Search for more papers by this author

Abstract

Introduction: The functional restoration of wrist and finger extension after complete brachial plexus avulsion injury remains an unsolved problem. We conducted a prospective study to elucidate a new method for resolving this injury. Methods: Six patients with complete brachial plexus avulsion injury underwent a new surgical procedure in which the full-length phrenic nerve was transferred to the medial portion of the radial nerve at the level of the latissimus dorsi insertion via endoscopic thoracic surgery. Results: In 5 patients, extensor carpi ulnaris and extensor carpi radialis strength recovered to Medical Research Council grade ≥M3, and in 4 patients extensor digitorum strength recovered to ≥M3. Conclusions: Neurotization of phrenic nerve to the medial portion of the radial nerve at the level of latissimus dorsi insertion is a feasible means of restoring wrist and finger extension in cases of complete brachial plexus avulsion injury. Muscle Nerve 45: 39–42, 2012

Ancillary