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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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10-year experience with nerve transfers for restoration of elbow function in patients with traumatic brachial plexus injuries

Meeting Abstract

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  • Julia Oberhoffer - Abteilung für Neurochirurgie am Bezirkskrankenhaus Günzburg, Universität Ulm
  • Gregor Antoniadis - Abteilung für Neurochirurgie am Bezirkskrankenhaus Günzburg, Universität Ulm
  • Ralph W. König - Abteilung für Neurochirurgie am Bezirkskrankenhaus Günzburg, Universität Ulm
  • Christian Heinen - Abteilung für Neurochirurgie, Evangelisches Krankenhaus Oldenburg, European Medical School, Oldenburg
  • Thomas Kretschmer - Abteilung für Neurochirurgie, Evangelisches Krankenhaus Oldenburg, European Medical School, Oldenburg
  • Christian R. Wirtz - Abteilung für Neurochirurgie am Bezirkskrankenhaus Günzburg, Universität Ulm
  • Maria T. Pedro - Abteilung für Neurochirurgie am Bezirkskrankenhaus Günzburg, Universität Ulm

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocDI.07.12

doi: 10.3205/13dgnc226, urn:nbn:de:0183-13dgnc2260

Published: May 21, 2013

© 2013 Oberhoffer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: In recent years nerve transfers have been increasingly used to broaden reconstructive options for brachial plexus injuries. We reviewed the clinical outcome of our patients who have undergone different nerve transfers for restoration of elbow flexion during the last ten years (2002–2012).

Method: We retrospectively analyzed the medical records, electrophysiological examinations and radiological images of 107 patients who underwent nerve transfer operation between 01/2002 and 12/2011. Pre- and postoperative assessment of motor function was carried out using the Medical Research Council (MRC) grading scale.

Results: During 01/2002 and 12/2011 a total of 107 patients with a brachial plexus injury were treated by nerve transfer surgery in our institute. Eight patients were lost to follow-up, leaving 99 patients. The average follow up was 23 months. In summary 75% of the patients recovered to MRC 3. The best results could be achieved by transferring the medial pectoral to musculocutaneous nerve(MCN), where 82% recovered to MRC 3. 74% of patients who have undergone an Oberlin transfer achieved the same muscle strength and 80% of those patients with median nerve to MCN regained MRC 3. The results of the following nerve transfers are not that encouraging: spinal accessory nerve to MCN (24%), phrenic nerve to MCN (17%) and intercostal to MCN (0%).

Conclusions: Nerve transfers for repair of brachial plexus injuries lead to excellent elbow functions. Especially transferring of the medial pectoral nerve to MCN and the Oberlin procedure result in encouraging outcomes.