scholarly journals Triceps Innervation Pattern: Implications for Triceps Nerve to Deltoid Nerve Transfer

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Obaid Al-Meshal ◽  
Alain Gilbert
Keyword(s):  
Anatomical Study ◽  
Nerve Transfer ◽  
Deltoid Muscle ◽  
Innervation Pattern ◽  
Anatomical Studies ◽  
Triceps Muscle ◽  
Muscle Innervation ◽  
Long Head ◽  
Lateral Head ◽  
Single Branch

There are multiple nerve branches supplying the triceps. Traditionally, the nerve to the long head of triceps is utilized for nerve transfer to neurotize the deltoid muscle in patients with brachial plexus injuries. However, no anatomical studies were done to investigate which triceps nerve would be preferred for nerve transfer. This anatomical study was carried out to describe the innervation pattern of the triceps muscle to investigate the preferred triceps nerve for nerve transfer. Twenty-five cadaveric arms were dissected. The long head of the triceps received a single branch in 23 cases (92%) and double branches in 2 cases (8%) only. The medial head had a single branch in 22 cases (88%) and double branches in 3 cases (12%). The lateral head was the most bulky one and received more than one branch in all cases (100%), ranging from 2 to 5 branches. The transfer of the most proximal branch to the lateral head of the triceps seems to be the most preferred choice for deltoid muscle innervation.

scholarly journals Surgical Implications of Innervation Pattern of the Triceps Muscle: A Cadaveric Study

2018 ◽  
Vol 10 (03) ◽  
pp. 139-142 ◽  
Author(s):  
Prashant Chaware ◽  
John Santoshi ◽  
Manmohan Patel ◽  
Mohtashim Ahmad ◽  
Bertha Rathinam
Keyword(s):  
Radial Nerve ◽  
Axillary Nerve ◽  
Nerve Supply ◽  
Upper Limbs ◽  
Innervation Pattern ◽  
Medial Head ◽  
Triceps Muscle ◽  
Muscle Transfers ◽  
Long Head ◽  
Lateral Head

AbstractThe innervation pattern of triceps is complex and not fully comprehended. Anomalous innervations of triceps have been described by various authors. We have attempted to delineate the nerve supply of the triceps and documented the anomalous innervations of its different heads. The brachial plexus and its major branches (in the region of the axilla and arm) and triceps were dissected in 36 embalmed cadaver upper limbs. Long head received one branch from radial nerve in 31 (86%) specimens. Four (11%) specimens received two branches including one that had dual innervation from the radial and axillary nerves, and one (3%) specimen had exclusive innervation from a branch of the axillary nerve. Medial head received two branches arising from the radial nerve in 34 (94%) specimens. One (3%) specimen received three branches from the radial nerve whereas one (3%) had dual supply from the radial and ulnar nerves. Lateral head received multiple branches exclusively from the radial nerve, ranging from 2 to 5, in all (100%) specimens. Knowledge of the variations in innervation of the triceps would not only help the surgeon to avoid inadvertent injury to any of the nerve branches but also offers new options for nerve and free functional muscle transfers.

scholarly journals Anatomical Study of Pronator Teres Muscle Innervation and Clinical Significance in Nerve Transfer

2018 ◽  
Vol 36 (4) ◽  
pp. 1500-1508
Author(s):  
Edie Benedito Caetano ◽  
Luiz Angelo Vieira ◽  
José João Sabongi-Neto ◽  
Maurício Benedito Ferreira Caetano ◽  
Rodrigo Guerra Sabongi ◽  
...  
Keyword(s):  
Clinical Significance ◽  
Anatomical Study ◽  
Nerve Transfer ◽  
Pronator Teres ◽  
Muscle Innervation

scholarly journals Ulnar nerve contribution in the innervation of the triceps brachii muscle ulnar nerve to the triceps brachii

1970 ◽  
Vol 6 (1) ◽  
pp. 834-839
Author(s):  
DLR Silva ◽  
MP Barros ◽  
TGS Freire ◽  
L Firmino Júnior ◽  
WRB Almeida Filho ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Terminal Branch ◽  
Upper Limbs ◽  
Triceps Brachii ◽  
Medial Head ◽  
Muscle Innervation ◽  
Triceps Brachii Muscle ◽  
Long Head ◽  
Lateral Head

The ulnar nerve is considered the thickest terminal branch of the medial cord in the brachial plexus and most authors does not mention the possibility of this nerve emitting branches to the arm. However, some studies reported that the ulnar nerve could supply the medial head of triceps brachii muscle. The main objective in this study was identifying the presence of ulnar nerve branches in triceps brachii muscle. Sixty upper limbs of adult Brazilian corpses of both sexes were used. The estimated age was between 25 and 80 years old. Every studied piece had the nerves and their branches quantified and measured with a manual mechanic caliper. The branches were photographed and had the data registered in individual files. Were found ulnar nerve branches for all the heads of triceps brachii muscle: 1 branch (9,1%) to lateral head, 2 branches (18,1%) to long head and 8 branches (72,7%) to medial head. Thus, we can conclude that the contribution of ulnar nerve to triceps brachii muscle constitutes an important anatomical variation.Key words: Ulnar nerve; Triceps brachii muscle; Innervation.

scholarly journals Radial to axillary nerve transfer

2018 ◽  
Vol 44 (videosuppl1) ◽  
pp. V1 ◽  
Author(s):  
Vicente Vanaclocha ◽  
Juan Manuel Herrera ◽  
Marlon Rivera-Paz ◽  
Deborah Martínez-Gómez ◽  
Leyre Vanaclocha
Keyword(s):  
Nerve Transfer ◽  
Axillary Nerve ◽  
Negative Consequences ◽  
Viable Option ◽  
Successful Result ◽  
Nerve Branch ◽  
Triceps Muscle ◽  
Traditional Procedure ◽  
Muscle Nerve ◽  
Long Head

Axillary nerve injury is common after brachial plexus injuries, particularly with shoulder luxation. Nerve grafting is the traditional procedure for postganglionic injuries. Nerve transfer is emerging as a viable option particularly in late referrals. At the proximal arm the radial and axillary nerves lie close by. Sacrificing one of the triceps muscle nerve branches induces little negative consequences. Transferring the long head of the triceps nerve branch is a good option to recover axillary nerve function. The surgical technique is presented in a video, stressing the steps to achieve a successful result.The video can be found here: https://youtu.be/WbVbpMuPxIE.

Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study

2003 ◽  
Vol 28 (4) ◽  
pp. 628-632 ◽  
Author(s):  
Kiat Witoonchart ◽  
Somsak Leechavengvongs ◽  
Chairoj Uerpairojkit ◽  
Phairat Thuvasethakul ◽  
Vudthipong Wongnopsuwan
Keyword(s):  
Feasibility Study ◽  
Nerve Transfer ◽  
Deltoid Muscle ◽  
Long Head

Outcome after transfer of intercostal nerves to the nerve of triceps long head in 25 adult patients with total brachial plexus root avulsion injury

2013 ◽  
Vol 118 (3) ◽  
pp. 606-610 ◽  
Author(s):  
KaiMing Gao ◽  
Jie Lao ◽  
Xin Zhao ◽  
YuDong Gu
Keyword(s):  
Brachial Plexus ◽  
Phrenic Nerve ◽  
Nerve Transfer ◽  
Effective Rate ◽  
Root Avulsion ◽  
Factors Affecting ◽  
Triceps Muscle ◽  
Significant Difference ◽  
Long Head ◽  
Intercostal Nerves

Object The intercostal nerves (ICNs) have been used to repair the triceps branch in some organizations in the world, but the reported results differ significantly. The effect of this procedure requires evaluation. Thus, this study aimed to evaluate the outcome of ICN transfer to the nerve of the long head of the triceps muscle and to determine the factors affecting the outcome of this procedure. Methods A retrospective review was conducted in 25 patients with global root avulsion brachial plexus injuries who underwent ICN transfer. The nerves of the long head of the triceps were the recipient nerves in all patients. The ICNs were used in 2 different ways: 2 ICNs were used as donor nerves in 18 patients, and 3 ICNs were used in 7 patients. The mean follow-up period was 5.6 years. Results The effective rate of motor recovery in the 25 patients was 56% for the function of the long head of the triceps. There was no significant difference in functional recovery between the patients with 2 or 3 ICN transfers. The outcome of this procedure was not altered if combined with phrenic nerve transfer to the biceps branch. Patients in whom surgery was delayed 6 months or less achieved better results. Conclusions The transfer of ICNs to the nerve of long head of the triceps is an effective procedure for treating global brachial plexus avulsion injuries, even if combined with phrenic nerve transfer to the biceps branch. Two ICNs appear to be sufficient for donation. The earlier the surgery is performed, the better are the results achieved.

Nerve Transfer to the Deltoid Muscle Using the Nerve to the Long Head of the Triceps with the da Vinci Robot: Six Cases

2014 ◽  
Vol 30 (06) ◽  
pp. 375-380 ◽  
Author(s):  
Hideaki Miyamoto ◽  
Somsak Leechavengvongs ◽  
Teddy Atik ◽  
Sybille Facca ◽  
Philippe Liverneaux
Keyword(s):  
Da Vinci ◽  
Nerve Transfer ◽  
Deltoid Muscle ◽  
Da Vinci Robot ◽  
Long Head

Triceps Motor Nerve Branches as a Donor or Receiver in Nerve Transfers

2007 ◽  
Vol 61 (suppl_5) ◽  
pp. ONS333-ONS339 ◽  
Author(s):  
Jayme A. Bertelli ◽  
Marcos A. Santos ◽  
Paulo R. Kechele ◽  
Marcos F. Ghizoni ◽  
Hamilton Duarte
Keyword(s):  
Radial Nerve ◽  
Latissimus Dorsi ◽  
Motor Nerve ◽  
Nerve Transfer ◽  
Motor Branch ◽  
Medial Head ◽  
Nerve Transfers ◽  
Axillary Region ◽  
Long Head ◽  
Lateral Head

AbstractObjective:The pattern of triceps innervation is complex and, as yet, has not been fully elucidated. The purposes of this study were 1) to clarify the anatomy of the triceps motor branches, and 2) to evaluate their possible uses as a donor or receiver for nerve transfer.Methods:The radial nerve and its motor and cutaneous branches were bilaterally dissected from the axilla and posterior arm regions of 10 embalmed cadavers.Results:A single branch innervates the triceps long head, whereas double innervation was identified for the lateral and medial heads. The upper branch to the lateral head originated from the radial nerve, whereas the lower branch to the lateral head stemmed from the lower medial head motor branch, which ultimately innervated the anconeus muscle. Both the long head and the upper medial head motor branches originated in the axillary region in the vicinity of the latissimus dorsi tendon.Conclusion:Each of the triceps’ motor branches might be used as a donor for transfer. The triceps long head motor branch should be used preferentially when the intention is to establish triceps reinnervation.

Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: a report of 7 cases

2003 ◽  
Vol 28 (4) ◽  
pp. 633-638 ◽  
Author(s):  
Somsak Leechavengvongs ◽  
Kiat Witoonchart ◽  
Chairoj Uerpairojkit ◽  
Phairat Thuvasethakul
Keyword(s):  
Nerve Transfer ◽  
Deltoid Muscle ◽  
Long Head

Transfer of a Motor Fascicle From the Ulnar Nerve to the Branch of the Radial Nerve Destined to the Long Head of the Triceps for Restoration of Elbow Extension in Brachial Plexus Surgery

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. E516-E520 ◽  
Author(s):  
Leandro Pretto Flores
Keyword(s):  
Computed Tomography ◽  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Radial Nerve ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Shoulder Abduction ◽  
Elbow Extension ◽  
Long Head ◽  
Brachial Plexus Surgery

Abstract BACKGROUND AND IMPORTANCE: Restoration of elbow extension has not been considered of much importance regarding functional outcomes in brachial plexus surgery; however, the flexion of the elbow joint is only fully effective if the motion can be stabilized, what can be achieved solely if the triceps brachii is coactivated. To present a novel nerve transfer of a healthy motor fascicle from the ulnar nerve to the nerve of the long head of the triceps to restore the elbow extension function in brachial plexus injuries involving the upper and middle trunks. CLINICAL PRESENTATION: Case 1 is a 32-year-old man sustaining a right brachial extended upper plexus injury in a motorcycle accident 5 months before admission. The computed tomography myelogram demonstrated avulsion of the C5 and C6 roots. Case 2 is a 24-year-old man who sustained a C5-C7 injury to the left brachial plexus in a traffic accident 4 months before admission. Computed tomography myelogram demonstrated signs of C6 and C7 root avulsion. The technique included an incision at the medial border of the biceps, in the proximal third of the involved arm, followed by identification of the ulnar nerve, the radial nerve, and the branch to the long head of the triceps. The proximal stump of a motor fascicle from the ulnar nerve was sutured directly to the distal stump of the nerve of the long head of the triceps. Techniques to restore elbow flexion and shoulder abduction were applied in both cases. Triceps strength Medical Research Council M4 grade was obtained in both cases. CONCLUSION: The attempted nerve transfer was effective for restoration of elbow extension in primary brachial plexus surgery; however, it should be selected only for cases in which other reliable donor nerves were used to restore elbow flexion.

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