Treatment of brachial plexus injury with modified contralateral C7 transfer

To study the curative effects of different surgical methods using a contralateral C(7) transfer technique for treatment of brachial plexus injury induced by root avulsion.

Sixty-four patients with brachial plexus injury due to root avulsion were divided into two groups: 30 patients were included in Group A and 34 in Group B. In Group A, the contralateral C(7) roots were partially transected and anastomosed to one end of an ulnar nerve graft which had been removed from the affected limb. The other end of the ulnar nerve was divided into two parts and anastomosed to the distal ends of the recipient median and radial nerves, respectively. In Group B, the whole of the contralateral C(7) roots was transected and anastomosed to one side of an ulnar nerve graft, the other side of which was anastomosed eight months later to the distal ends of the recipient median and radial nerves. All subjects were followed up and the outcomes assessed.

Neurological deficit and recovery time of the donor limb in group A were less than those in group B. The nerve transfer procedure to the affected limb was easily completed in group A with less morbidity, and the tension of the stoma in group A was less than that in group B. However, there was no statistical difference between group A and B in the recovery of motor function and results of electrophysiological testing of the affected side (P > 0.05).

The method of partial C(7) root transfer results in equally good motor function as does transfer of the whole root, while occurrence of motor and sensory damage is less than that which occurs with transfer of the whole root.