Clinical application of pectoral nerve transfers in the treatment of traumatic brachial plexus injuries.

摘要

PURPOSE: To determine the effectiveness, reliability and donor site morbidity of pectoral nerve transfers in the treatment of brachial plexus lesions. METHODS: This retrospective study included 6 patients with 7 pectoral nerve transfers. The follow-up examination comprised measurement of the ranges of motion (AO neutral-0 method), functional muscle testing (British Medical Research Council), and photo- and videographic documentation. RESULTS: Three patients achieved excellent results (M5, M4), in 3 cases good muscle function was achieved (M3) and 1 patient, who had a short follow-up period, revealed M2 motor function. CONCLUSIONS: This study describes the treatment of patients with conditions far from ideal. All patients sustained extensive brachial plexus lesions and most had severe associated injuries of the upper limb, which limited the availability of sufficient donor nerves. Despite these facts, 6 cases had excellent or good results and 1 showed continuing improvement of muscle function. These good results and the excellent results documented in literature demonstrate the high dependability and efficiency of the pectoral nerves as donors in the treatment of brachial plexus lesions. Furthermore, it was shown that free functioning muscle transplants can be sufficiently reinnervated by pectoral nerves. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.