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Contralateral C7 transfer for the treatment of upper obstetrical brachial plexus palsy
Haodong Lin1, Chunlin Hou, Desong Chen
1Department of Orthopedic Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, People's Republic of China.
Insights
Contralateral C7 transfer effectively restores upper limb function in infants with obstetrical brachial plexus palsy (OBPP). This surgical technique shows promising results for nerve reconstruction in affected infants.
Area of Science:
- Neurosurgery
- Pediatric Orthopedics
- Microsurgery
Background:
- Obstetrical brachial plexus palsy (OBPP) can lead to significant upper limb dysfunction in infants.
- Contralateral C7 nerve transfer is an infrequently utilized surgical option for OBPP.
- Optimal application and outcomes of this procedure require further elucidation.
Purpose of the Study:
- To evaluate the efficacy of contralateral C7 transfer in infants with upper OBPP.
- To define the optimal application and predict the outcomes of this nerve transfer.
- To assess the impact of patient age on surgical success.
Main Methods:
- A cohort of 15 infants with upper brachial plexus injuries underwent contralateral C7 transfer.
- The common trunk of the contralateral C7 root was grafted to the affected side's upper trunk or lateral cord.
- Surgical outcomes were analyzed, correlating functional recovery with patient age at the time of transfer.
Main Results:
- Follow-up averaged 46.8 months.
- Significant motor function (≥M2+) was achieved in 11 out of 15 patients.
- All patients demonstrated improved sensory function (≥S3).
- Patient age at the time of nerve transfer did not significantly influence the surgical outcome.
Conclusions:
- Contralateral C7 transfer is a viable and effective surgical procedure for infants diagnosed with OBPP.
- This technique facilitates the restoration of upper limb motor and sensory function in cases of root avulsions.
- The study supports the use of contralateral C7 transfer as a reconstructive option in select pediatric brachial plexus injuries.
Purpose:
The use of contralateral C7 is seldom indicated in infants with obstetrical brachial plexus palsy (OBPP). The purpose of this study was to evaluate the value of contralateral C7 transfer in infants with upper OBPP in order to define the application and outcome of this transfer in these infants more optimally.
Methods:
Over a 5-year period, 15 infants with upper brachial plexus injuries underwent transfer of the contralateral C7 as part of the primary surgical reconstruction. The common trunk of the contralateral C7 root was transferred to the upper trunk or lateral cord on the affected side with nerve graft. The efficacy of the surgery and effects of patient age at the time of nerve transfer were analyzed.
Results:
Patients were followed up for a mean duration of 46.8 months. Noteworthy function (≥M2+) was gained in 11 of 15 patients, and sensory function (≥S3, MRC grading system) was gained in all patients. Age was not the factor related to the outcome of this surgery.
Conclusions:
Contralateral C7 transfer is an effective procedure for the restoration of upper limb function in infants with OBPP and root avulsions.
