Restoring musculocutaneous nerve function in 146 brachial plexus operations - A retrospective analysis

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Brachial plexus lesions, often caused by trauma, severely impact upper extremity function, particularly elbow flexion.
• Restoring elbow flexion is critical for functional recovery and independence in affected individuals.

Purpose of the Study:

• To compare the outcomes of different surgical methods for musculocutaneous nerve reconstruction following brachial plexus injury.
• To identify predictors of successful functional recovery after these procedures.

Main Methods:

• Retrospective analysis of 146 brachial plexus surgeries involving musculocutaneous reconstruction (2013-2017).
• Evaluation of demographic data, surgical techniques, nerve characteristics, BMI, and functional outcomes (MRC strength grades).
• Multivariate analysis using SPSS to determine significant predictors of outcome.

Main Results:

• Oberlin reconstruction was the most frequent procedure.
• Nerve transfer and autologous repair demonstrated similar functional outcomes.
• No significant difference in outcome was observed between nerve transfers with or without nerve grafts.
• Younger patient age was identified as a strong predictor of better outcomes.
• Longer nerve graft length (>15 cm) and higher BMI (>25) were associated with inferior results.

Conclusions:

• Musculocutaneous nerve reconstruction leads to substantial clinical improvement in brachial plexus injuries.
• Nerve transfer and autologous reconstruction are equally effective.
• Younger age is an independent predictor of superior clinical outcomes.
• Further prospective multicenter studies are warranted to validate these findings.