Nerve transfer to biceps to restore elbow flexion and supination in children with obstetrical brachial plexus palsy

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Structured Motor Rehabilitation After Selective Nerve Transfers
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Structured Motor Rehabilitation After Selective Nerve Transfers

Published on: August 15, 2019

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J Murison1, P Jehanno2, F Fitoussi1

  • 1Department of Pediatric Orthopedic and Reconstructive Surgery, Trousseau Hospital, Paris 6 University, Paris, France.

Journal of Children'S Orthopaedics
|December 22, 2017
PubMed

Insights

Nerve transfers to the biceps motor branch can restore elbow flexion and forearm supination in infants with obstetrical brachial plexus palsy. This procedure is safe and effective for selected patients up to two years old.

Area of Science:

  • Pediatric Surgery
  • Neurology
  • Orthopedics

Background:

  • Restoring elbow flexion in infants with brachial plexus palsy is challenging.
  • Nerve transfers are an option but less studied in pediatric cases.

Purpose of the Study:

  • To evaluate the efficacy of nerve transfers to the biceps motor branch for improving elbow flexion and supination in infants with obstetrical brachial plexus palsy.
  • To assess the safety and optimal age for this procedure.

Main Methods:

  • Ten infants with obstetrical brachial plexus palsy underwent ulnar or median nerve transfer to the biceps motor branch.
  • Elbow flexion and forearm supination were assessed using the Active Movement Scale (AMS).
  • Follow-up averaged 2.6 years, with surgery at a mean age of 12.5 months.

Main Results:

  • Significant improvement in elbow flexion (AMS 0.3 to 5.7) and forearm supination (AMS 0.6 to 5.8) was observed.
  • No correlation found between age at surgery and post-operative AMS scores at 18 months.
  • The procedure was safely performed in all patients.

Conclusions:

  • Nerve transfer to the biceps motor branch is a viable option for improving upper limb function in selected infants with brachial plexus palsy.
  • The procedure can be safely performed in children up to two years of age.
  • This technique offers functional recovery for elbow flexion and forearm supination.
Abstract

Keywords:
elbow flexionnerve transferobstetrical brachial plexus palsy

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