scholarly journals Medial Pectoral Nerve to Axillary Nerve Neurotization following Traumatic Brachial Plexus Injuries: Indications and Clinical Outcomes

Hand ◽  
2011 ◽  
Vol 7 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Wilson Z. Ray ◽  
Rory K. J. Murphy ◽  
Katherine Santosa ◽  
Philip J. Johnson ◽  
Susan E. Mackinnon
Keyword(s):  
Brachial Plexus ◽  
Clinical Outcomes ◽  
Axillary Nerve ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve

scholarly journals Collateral branches of the brachial plexus as donors in nerve transfers

2012 ◽  
Vol 69 (7) ◽  
pp. 594-603 ◽  
Author(s):  
Miroslav Samardzic ◽  
Lukas Rasulic ◽  
Novak Lakicevic ◽  
Vladimir Bascarevic ◽  
Irena Cvrkota ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Statistical Significance ◽  
Axillary Nerve ◽  
Shoulder Abduction ◽  
Quality Of Recovery ◽  
Nerve Transfers ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve ◽  
Thoracodorsal Nerve

Background/Aim. Nerve transfers in cases of directly irreparable, or high level extensive brachial plexus traction injuries are performed using a variety of donor nerves with various success but an ideal method has not been established. The purpose of this study was to analyze the results of nerve transfers in patients with traction injuries to the brachial plexus using the thoracodorsal and medial pectoral nerves as donors. Methods. This study included 40 patients with 25 procedures using the thoracodorsal nerve and 33 procedures using the medial pectoral nerve as donors for reinnervation of the musculocutaneous or axillary nerve. The results were analyzed according to the donor nerve, the age of the patient and the timing of surgery. Results. The total rate of recovery for elbow flexion was 94.1%, for shoulder abduction 89.3%, and for shoulder external rotation 64.3%. The corresponding rates of recovery using the thoracodorsal nerve were 100%, 93.7% and 68.7%, respectively. The rates of recovery with medial pectoral nerve transfers were 90.5%, 83.3% and 58.3%, respectively. Despite the obvious differences in the rates of recovery, statistical significance was found only between the rates and quality of recovery for the musculocutaneous and axillary nerve using the thoracodorsal nerve as donor. Conclusion. According to our findings, nerve transfers using collateral branches of the brachial plexus in cases with upper palsy offer several advantages and yield high rate and good quality of recovery.

Transfer of the Medial Pectoral Nerve: Myth or Reality?

Neurosurgery ◽  
2002 ◽  
Vol 50 (6) ◽  
pp. 1277-1282 ◽  
Author(s):  
Miroslav Samardzic ◽  
Danica Grujicic ◽  
Lukas Rasulic ◽  
Dragoljub Bacetic
Keyword(s):  
Functional Recovery ◽  
Time Course ◽  
Nerve Transfer ◽  
Spinal Nerve ◽  
Axillary Nerve ◽  
Musculocutaneous Nerve ◽  
Strong Trend ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve ◽  
Significant Difference

Abstract OBJECTIVE Transfer of the medial pectoral nerve is one of the most controversial procedures used to reinnervate the paralyzed upper arm because of brachial plexus spinal nerve root avulsion or directly irreparable proximal lesions of spinal nerves. The purpose of this study was to determine the value of this type of nerve transfer to the musculocutaneous and axillary nerves. METHODS The 25 patients included in the study comprised 14 patients who had nerve transfer to the musculocutaneous nerve and 11 who underwent nerve transfer to the axillary nerve. These patients’ functional recovery and the time course of their recovery were analyzed according to the type of transfer of one donor nerve or the donor nerve in combination with other donors. RESULTS Useful functional recovery was achieved in 85.7% of patients who had nerve transfer to the musculocutaneous nerve and in 81.8% of patients who underwent nerve transfer to the axillary nerve. There was no significant difference in results with regard to the type of nerve transfer and which recipient nerves were involved. A strong trend toward better results after procedures involving the use of a donor nerve combined with other donors was observed, however. CONCLUSION Our surgical results suggest that the transfer of the medial pectoral nerve to the musculocutaneous nerve and also to the axillary nerve may be a reliable and effective procedure.

Medial pectoral nerve to musculocutaneous nerve neurotization for the treatment of persistent birth-related brachial plexus palsy: an 11-year institutional experience

2009 ◽  
Vol 3 (5) ◽  
pp. 348-353 ◽  
Author(s):  
John C. Wellons ◽  
R. Shane Tubbs ◽  
Jeffrey A. Pugh ◽  
Nadine J. Bradley ◽  
Charles R. Law ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Functional Recovery ◽  
Traumatic Injury ◽  
Elbow Flexion ◽  
Musculocutaneous Nerve ◽  
Brachial Plexus Palsy ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve ◽  
Institutional Experience

Object Medial pectoral nerve (MPN) to musculocutaneous nerve (MCN) neurotization for recovery of elbow flexion by biceps reinnervation is a valid option following traumatic injury to the upper brachial plexus. A major criticism of the application of this technique in infants is the smaller size of the MPN and mismatch of viable axons. We describe our institutional experience utilizing this procedure and critically examine functional outcomes. Methods Office charts and hospital records of children from over an 11-year period beginning January 1997 were reviewed. Of the 53 children of various ages undergoing brachial plexus exploration for traumatic injury of any nature, 20 underwent MPN to MCN neurotization as a part of an overall procedure in the first year of life to treat birth-related brachial plexus palsy and had at least 9 months' follow-up. Medial pectoral nerve to MCN neurotization was chosen if the results of clinical examination and intraoperative electrophysiological evidence were consistent with medial cord function. Functional recovery was defined as the ability of the child to bring their hand to their mouth. Results Sixteen patients (80%) gained functional recovery. The median age at surgery was 7 months. Median time to first clinic visit documenting recovery was 11.5 months and median overall follow up was 21.5 months. Preoperative hand function was a useful predictor of recovery of elbow flexion. Conclusions Medial pectoral nerve to MCN neurotization is a valid surgical option for the reinnervation of the biceps muscle for birth-related brachial plexus palsy when the hand is functional preoperatively. Useful elbow flexion can be expected in the majority of these children.

Intercostal and pectoral nerve transfers to re-innervate the biceps muscle in obstetric brachial plexus lesions

2013 ◽  
Vol 39 (6) ◽  
pp. 647-652 ◽  
Author(s):  
W. Pondaag ◽  
M. J. A. Malessy
Keyword(s):  
Brachial Plexus ◽  
Nerve Transfer ◽  
Intercostal Nerve ◽  
Consecutive Series ◽  
Biceps Muscle ◽  
Nerve Transfers ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve ◽  
Obstetric Brachial Plexus ◽  
Transfer Group

In obstetric brachial plexus lesions with avulsion injury, nerve grafting for biceps muscle re-innervation may not be possible owing to the unavailability of a proximal stump. In such cases, the intercostal nerves or medial pectoral nerve can serve as donor nerves in an end-to-end transfer to the musculocutaneous nerve. The present study reports the results of both techniques from a single institution in a consecutive series of 42 patients between 1995 and 2008. From 1995 to 2000 we always used the intercostal nerve transfer, and from 2001 to 2008 both techniques were used. Biceps muscle force ≥Medical Research Council Grade 3 was achieved in 37 of 42 patients after a mean follow-up of 44 months. There was no statistical difference in the results in the medial pectoral nerve transfer group ( n = 25) and the intercostal nerve transfer group ( n = 17).

scholarly journals A Case Report of a Rare Variation in the Lateral Cord of the Brachial Plexus

2021 ◽  
Author(s):  
Seyed Abbas Datli Beigi ◽  
Abbas Shahedi
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Upper Limb ◽  
The Body ◽  
Medical Sciences ◽  
Rare Variation ◽  
Lateral Cord ◽  
Clinical Complications ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve

The brachial plexus is the largest and most complex neural plexus in the body located in the neck and axilla. So far, there have been many reports of various variations in the brachial plexus that are of clinical significance. In the present study, while dissecting the upper limb of a 54-year-old man in the dissection room of Shahid Sadoughi University of Medical Sciences in Yazd, a rare variation was observed in the lateral cord branches of the plexus. In this case, the medial pectoral nerve, which normally separates from the medial cord, originated from the lateral cord. Awareness of this variation is important for anatomists, surgeons, anesthesiologists and radiologists to interpret the graphs, etc., and can help to reduce clinical complications during surgery and better interpret and diagnose the graphs.  

Reanimation of elbow extension with medial pectoral nerve transfer in partial injuries to the brachial plexus

2013 ◽  
Vol 118 (3) ◽  
pp. 588-593 ◽  
Author(s):  
Leandro Pretto Flores
Keyword(s):  
Brachial Plexus ◽  
Radial Nerve ◽  
Research Council ◽  
Medical Research Council ◽  
Nerve Transfer ◽  
Elbow Extension ◽  
Triceps Brachii ◽  
Pectoral Nerve ◽  
Medial Pectoral Nerve ◽  
Long Head

Object Recent advancements in operative treatment of the brachial plexus authorized more extensive repairs and, currently, elbow extension can be included in the rank of desirable functions to be restored. This study aims to describe the author's experience in using the medial pectoral nerve for reinnervation of the triceps brachii in patients sustaining C5–7 palsies of the brachial plexus. Methods This is a retrospective study of the outcomes regarding recovery of elbow extension in 12 patients who underwent transfer of the medial pectoral nerve to the radial nerve or to the branch of the long head of the triceps. Results The radial nerve was targeted in 3 patients, and the branch to the long head of the triceps was targeted in 9. Grafts were used in 6 patients. Outcomes assessed as Medical Research Council Grades M4 and M3 for elbow extension were noted in 7 (58%) and 5 (42%) patients, respectively. Conclusions The medial pectoral nerve is a reliable donor for elbow extension recovery in patients who have sustained C5–7 nerve root injuries.

scholarly journals The Structure of the Brachial Plexus of the Djungarian Hamster (Phodopus sungorus)

2022 ◽  
Author(s):  
Arkadiusz Grzeczka ◽  
Maciej Zdun
Keyword(s):  
Brachial Plexus ◽  
Companion Animals ◽  
Suprascapular Nerve ◽  
Axillary Nerve ◽  
Djungarian Hamster ◽  
Scientific Publications ◽  
Long Thoracic Nerve ◽  
Thoracic Nerve ◽  
Pectoral Nerve ◽  
Thoracodorsal Nerve

AbstractHamsters are often chosen as companion animals but are also a group of animals frequently subjected to laboratory tests. As there are no scientific publications providing information on the anatomical architecture of the brachial plexus of the Djungarian hamster, this study analyses the structure of this part of the nervous system of this species. It is important to know the details of this structure not only for cognitive reasons, but also due to the increasing clinical significance of rodents, which are often used in scientific research. The study was conducted on 55 specimens. Like in humans, the brachial plexus of the Djungarian hamster has three trunks. The following individual nerves innervating the thoracic limb of the Djungarian hamster: the radial nerve, median nerve, ulnar nerve, musculocutaneous nerve, axillary nerve, suprascapular nerve, thoracodorsal nerve, cranial pectoral nerves, caudal pectoral nerve, lateral thoracic nerve, long thoracic nerve, and subscapular nerves. Similarly to other mammals of this order, the brachial plexus of the Djungarian hamster ranges widely (C5-T1). However, its nerves are formed from different ventral branches of the spinal nerves than in other mammals.

scholarly journals Cadaveric evaluation of the feasibility of glenohumeral joint denervation

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Amr M. Aly
Keyword(s):  
Muscle Weakness ◽  
Shoulder Joint ◽  
Glenohumeral Joint ◽  
Axillary Nerve ◽  
Low Risk ◽  
Dorsal Approach ◽  
Articular Branch ◽  
Pectoral Nerve ◽  
Teres Minor

Abstract Purpose To assess the feasibility of total shoulder denervation through two proposed incisions. Methods Total shoulder denervation was performed through an extended delta-pectoral approach and a transverse dorsal approach at the spine of the scapula. The study involved six cadavers. Course and number of articular branches from the lateral pectoral, axillary and supra-scapular nerve were documented. Results All shoulder joint articular branches were accessible through the proposed anterior and posterior approaches. The articular branch of the lateral pectoral nerve and supra scapular nerve were present in all the specimen. Axillary nerve articular branches were variable in number but when present anteriorly were proximal to the deltoid muscular branches and posteriorly proximal to the muscular branches to the teres minor. Conclusion Total glenohumeral denervation was feasible through our proposed anterior and posterior approaches. Enhanced knowledge of articular nerve branches could provide interventional targets for joint and ligament pain, with low risk of muscle weakness.

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