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Updated: May 9, 2026
A Mouse Model of Direct Anastomosis via the Prespinal Route for Crossing Nerve Transfer Surgery
Published on: October 19, 2021
Surgical treatment for total root avulsion type brachial plexus injuries by neurotization: a prospective comparison
Yuan-Kun Tu1, Yi-Jung Tsai, Chih-Han Chang
1Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Purpose:
We conducted a clinical study to evaluate the effects of neurotization, especially comparing the total contralateral C7 (CC7) root transfer to hemi-CC7 transfer, on total root avulsion brachial plexus injuries (BPI).
Methods:
Forty patients who received neurotization for BPI were enrolled in this prospective study. Group 1 (n = 20) received hemi-CC7 transfer for hand function, while group 2 (n = 20) received total-CC7 transfer. Additional neurotization included spinal accessory, phrenic, and intercostal nerve transfer for shoulder and elbow function. The results were evaluated with an average of 6 years follow-up.
Results:
Group 1 had fewer donor site complications (15%) than group 2 (45%); group 2 had significantly better hand M3 and M4 motor function (65%) than group 1 (30%; P = 0.02). There was no difference in sensory recovery. Significantly, better shoulder function was obtained by simultaneous neurotization on both suprascapular and axillary nerves.
Conclusions:
Total-CC7 transfer had better hand recovery but more donor complications than hemi-CC7. Neurotization on both supra-scapular and axillary nerves improved shoulder recovery.
