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Shoulder function following partial spinal accessory nerve transfer for brachial plexus birth injury
John A I Grossman1, Patricia Di Taranto, Daniel Alfonso
1Brachial Plexus Program, Miami Children's Hospital, Miami, FL 33176, USA. info@handandnervespecialist.com
Summary
Spinal accessory nerve transfers to the suprascapular nerve improved shoulder function in infants with brachial plexus birth injuries. All patients achieved Grade 4 shoulder function, with average lateral rotation of 53 degrees.
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.