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Contralateral motor rootlets and ipsilateral nerve transfers in brachial plexus reconstruction
Jayme Augusto Bertelli1, Marcos Flávio Ghizoni
1Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, Brazil. bertelli@matrix.com.br
Journal of Neurosurgery
|November 16, 2004
Summary
Contralateral C-7 motor rootlet transfers effectively reconstruct shoulder abduction and external rotation in brachial plexus avulsion injuries. This nerve transfer technique shows promising outcomes, particularly for partial injuries, restoring crucial arm function.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Brachial plexus avulsion injuries significantly impair upper extremity function, necessitating innovative reconstructive strategies.
- Restoring shoulder abduction, external rotation, and elbow flexion is critical for functional recovery.
Purpose of the Study:
- To evaluate the efficacy of contralateral C-7 motor rootlet and ipsilateral nerve transfers for reconstructing shoulder and elbow function in patients with brachial plexus avulsion injuries.
Main Methods:
- 24 patients with brachial plexus avulsion underwent contralateral C-7 motor rootlet to suprascapular nerve transfer with sural nerve grafts.
- Elbow flexion was reconstructed using ulnar nerve, 11th cranial nerve, or phrenic nerve transfers.
- Surgical interventions were performed within 6 months post-injury.
Main Results:
- Mean recovery of 90° abduction and 92° external rotation was achieved.
- Elbow flexion was successfully restored in all patients.
- Outcomes were significantly better in patients with partial injuries and those shorter than 170 cm.
Conclusions:
- Contralateral C-7 motor rootlet transfer is a reliable and effective neurotization technique for restoring shoulder abduction and external rotation.
- Nerve transfers provide a viable option for functional reconstruction following brachial plexus avulsion injuries.