Double nerve transfer for elbow flexion in obstetric brachial plexus injury: A case report

Summary We report a case of a 10-month-old boy with a left extended upper type (C5–C7) obstetric brachial plexus injury that was treated with double nerve transfer (partial ulnar and partial median nerve transfer) to restore elbow flexion and spinal accessory nerve transfer to the suprascapular nerv...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2013-03, Vol.66 (3), p.423-426
Main Authors: Estrella, Emmanuel P, Mella, Pierre M
Format: Article
Language:English
Subjects:
Birth Injuries - complications
Birth Injuries - surgery
Brachial Plexus Neuropathies - etiology
Brachial Plexus Neuropathies - surgery
Double nerve transfer
Elbow Joint - physiopathology
Elbow Joint - surgery
Follow-Up Studies
Humans
Infant
Male
Median Nerve - surgery
Median Nerve - transplantation
Nerve transfer
Nerve Transfer - methods
Obstetric palsy
Plastic Surgery
Range of Motion, Articular - physiology
Recovery of Function
Risk Assessment
Time Factors
Treatment Outcome
Ulnar Nerve - surgery
Ulnar Nerve - transplantation
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Summary:Summary We report a case of a 10-month-old boy with a left extended upper type (C5–C7) obstetric brachial plexus injury that was treated with double nerve transfer (partial ulnar and partial median nerve transfer) to restore elbow flexion and spinal accessory nerve transfer to the suprascapular nerve to restore shoulder abduction. At 60 months' follow-up, shoulder abduction was 0–150° (M4) and elbow flexion was 0–140° (M5). Elbow, wrist and finger extension improved to M5. However, shoulder external rotation was only 0–30° (from full internal rotation). No weakness on finger and wrist flexion was observed. Double nerve transfers to restore elbow flexion can be safely done in obstetric brachial plexus injuries with good results. Secondary surgeries may be needed to improve external rotation.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2012.06.012