Shoulder function following partial spinal accessory nerve transfer for brachial plexus birth injury

Area of Science:

• Pediatric Orthopedics
• Neurosurgery
• Reconstructive Surgery

Background:

• Brachial plexus birth injuries often result in significant shoulder dysfunction.
• Restoring shoulder function is crucial for long-term upper limb use in affected children.

Purpose of the Study:

• To evaluate the efficacy of partial spinal accessory nerve transfer to the suprascapular nerve in pediatric patients with brachial plexus birth injuries.
• To assess functional outcomes, including shoulder strength and range of motion, following this nerve transfer procedure.

Main Methods:

• A retrospective review of 26 infants undergoing partial spinal accessory nerve transfer to the suprascapular nerve for brachial plexus birth injury repair.
• Nerve grafting was utilized in all cases.
• Functional outcomes were assessed using the modified Gilbert Scale at a minimum follow-up of 2.5 years.

Main Results:

• All 26 patients achieved a modified Gilbert Scale shoulder function grade of 4 or better.
• The average lateral rotation of the shoulder was 53 degrees.
• The procedure demonstrated significant functional improvement in shoulder abduction and external rotation.

Conclusions:

• Partial transfer of the spinal accessory nerve to the suprascapular nerve is an effective surgical option for improving shoulder function in infants with brachial plexus birth injuries.
• This technique offers a promising solution for restoring shoulder control and improving the quality of life for affected children.