Comparative study of pronator teres branch transfer and brachialis motor branch transfer to the anterior interosseous nerve to treat lower brachial plexus injury in rats

2020 ◽  
Vol 73 (2) ◽  
pp. 231-241
Author(s):  
Lei Zhang ◽  
Chun-Lin Zhang ◽  
Tao Cai ◽  
Kun-Peng Zhu ◽  
Jian-Ping Hu ◽  
...  
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Motor Branch ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve

Origination of the Muscular Branches of the Median Nerve

Neurosurgery ◽  
2014 ◽  
Vol 76 (2) ◽  
pp. 196-200 ◽  
Author(s):  
Bin Xu ◽  
Zhen Dong ◽  
Cheng-Gang Zhang ◽  
Yi Zhu ◽  
Dong Tian ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Median Nerve ◽  
Brachial Plexus Injury ◽  
Electrophysiological Study ◽  
Nerve Roots ◽  
Motor Branch ◽  
Lower Trunk ◽  
Pronator Teres ◽  
Finger Flexion ◽  
Flexor Digitorum

ABSTRACT BACKGROUND: In lower brachial plexus injury, finger flexion after brachialis motor branch transfer is relatively weak. We sought to screen potential branches of the median nerve from the upper trunk for strengthening finger flexion in addition to the brachialis motor branch. However, the spinal origin of the muscular branches of the median nerve based on electrophysiological study was unclear. OBJECTIVE: To determine the spinal origin of the muscular branches of the median nerve. METHODS: An intraoperative electrophysiological study was carried out in 18 patients who underwent contralateral C7 nerve transfer. After exposure of the brachial plexus nerve roots on the healthy side, the amplitude of the compound muscle action potential of each median nerve-innervated muscle was recorded while the different nerve roots were stimulated. RESULTS: The pronator teres received fibers from C5, C6, and C7. It had more contribution from C5 and C6 than from C7 (P < .05). The flexor carpi radialis was innervated mainly by C6 and C7. The nerve branches of the palmaris longus and flexor digitorum superficialis stemmed primarily from C7 and the lower trunk, and no significant difference was found between them (P > .05). The flexor digitorum profundus, flexor pollicis longus, pronator quadratus, and abductor pollicis brevis were innervated predominantly by the lower trunk (P < .05). CONCLUSION: This electrophysiological study indicates that the pronator teres branch might be the most feasible alternative donor nerve to supplement the brachialis motor branch and strengthen finger flexion after lower brachial plexus injury.

Clinical use of supinator motor branch transfer to the posterior interosseous nerve in C7–T1 brachial plexus palsies

2010 ◽  
Vol 113 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Zhen Dong ◽  
Yu-Dong Gu ◽  
Cheng-Gang Zhang ◽  
Lei Zhang
Keyword(s):  
Brachial Plexus ◽  
Reliable Method ◽  
Nerve Transfer ◽  
Posterior Interosseous Nerve ◽  
Viable Option ◽  
Motor Branch ◽  
Finger Extension ◽  
Finger Flexion ◽  
Anterior Interosseous Nerve

Object In C7–T1 brachial plexus palsies, finger extension and flexion are absent. At the authors' institution, finger flexion has been successfully reconstructed by transferring the brachialis motor branch to the anterior interosseous nerve. However, there is no reliable method for restoring finger extension. In the present study, the authors examined the surgical results of transferring the supinator motor branch to the posterior interosseous nerve. Methods Since October 2007, the authors have performed a supinator motor branch transfer to the posterior interosseous nerve in 4 patients. The patients underwent follow-up every 3–4 months postoperatively. Results Finger extension appeared between 5 and 9 months in the first 3 cases and demonstrated promising improvement over time. One recent case remains under follow-up. Conclusions A supinator motor branch to posterior interosseous nerve transfer leads to reliable recovery of thumb and finger extension. Therefore, it is a viable option for C7–T1 brachial plexus palsies.

scholarly journals Outcome of double nerve transfer close to target muscle both for shoulder abduction and elbow flexion in early C5 –C6 Brachial Plexus injury.

2020 ◽  
Vol 27 (07) ◽  
pp. 1442-1447
Author(s):  
Husnain Khan ◽  
Muhammad Shafique ◽  
Zahid Iqbal Bhatti ◽  
Tehseen Ahmad Cheema
Keyword(s):  
Brachial Plexus ◽  
Posterior Approach ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Suprascapular Nerve ◽  
Axillary Nerve ◽  
Shoulder Abduction ◽  
Motor Branch ◽  
Nerve Transfers

Adult brachial plexus injury is a now a common problem due to high incidence of motorbike accidents. Among all types, C 5 and C6 (upper brachial plexus injury) is the most common. If the patient present within 6 months then nerve transfer is the preferred treatment. However, there are different options for nerve transfer and different approaches for surgery. Objectives: The objective of the study was to share our experience of nerve transfer close to target muscles in upper brachial plexus injury. Study Design: Quaisi experimental study. Setting: National Orthopaedic Hospital, Bahawalpur. Period: January 2015 to June 2018. Material & Methods: Total 32 patients were operated with isolated C5 and C6 injury. In all patients four nerve transfers were done. For shoulder abduction posterior approach was used and accessory to suprascapular nerve and one of motor branch of radial to axillary nerve were transferred. Modified Oberlin transfer was done for elbow flexion. Both shoulder abduction and elbow flexion was graded according to medical research council grading system. Results: After one year follow up more than 75% of the patients showed good to normal shoulder abduction and 87.50% showed good to normal elbow flexion. Residual Median nerve damage was noted only in two patients (6.25%). Conclusion: If there is no evidence of recovery up to three months early nerve transfer should be considered, ideal time is 3-6 months. Nerve transfer close to target muscle yields superior results. The shoulder stabilizers and abductors should ideally be innervated by double nerve transfer through posterior approach. Similarly double fascicular transfer (modified Oberlin) should be done for elbow flexion.

scholarly journals Proximal versus Distal Nerve Transfer for Biceps Reinnervation—A Comparative Study in a Rat’s Brachial Plexus Injury Model

2016 ◽  
Vol 4 (12) ◽  
pp. e1130 ◽  
Author(s):  
Aleksandra M. McGrath ◽  
Johnny Chuieng-Yi Lu ◽  
Tommy Naj-Jen Chang ◽  
Frank Fang ◽  
David Chwei-Chin Chuang
Keyword(s):  
Comparative Study ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Injury Model ◽  
Distal Nerve
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