Comparison Between Single and Double Nerve Transfers to Restore Elbow Flexion in Upper Plexus Palsies

摘要

The first goal of surgery in supraclavicular brachial plexus palsies is restoration of elbow flexion.In cases of upper brachial plexus palsy involving mainly, the loss of shoulder function and the flexion of the elbow, the C5 C6 and eventually C7 roots are often found avulsed from the medulla and this precludes nerve grafting. In such cases, conventional surgery involved palliative procedures such as a Steindler flexorplasty combined with arthrodesis of the shoulder or nerve transfers from nerves originating outside the brachial plexus such as spinal accessory to suprascapular and intercostals to musculocutaneous.We described the transfer of some fascicles from the intact ulnar nerve to the nerve to the biceps in 1994 (12), supported by several hypotheses: - the reinnervation of the biceps gives better results than palliative treatment, - in case of Erb's palsy, the closest normal nerve to the biceps is the ulnar nerve. This close proximity allows a direct repair that results in quick reinnervation of the biceps.