Successful recovery of sensation loss in upper brachial plexus injuries

Objective Injuries of the upper trunk of the brachial plexus may trigger motor and sensory deficits. There exists a growing body of literature with respect to the reconstruction of motor deficits in upper trunk brachial plexus injuries by using nerve transfers; albeit to date, very few old reports h...

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Bibliographic Details
Published in:Acta neurochirurgica 2018-10, Vol.160 (10), p.2019-2023
Main Authors: Emamhadi, Mohammadreza, Andalib, Sasan
Format: Article
Language:English
Subjects:
Brachial plexus
Finger
Fingers
Injuries
Interventional Radiology
Males
Medicine
Medicine & Public Health
Minimally Invasive Surgery
Nerves
Neurology
Neuroradiology
Neurosurgery
Original Article - Peripheral Nerves
Peripheral Nerves
Surgery
Surgical Orthopedics
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Summary:Objective Injuries of the upper trunk of the brachial plexus may trigger motor and sensory deficits. There exists a growing body of literature with respect to the reconstruction of motor deficits in upper trunk brachial plexus injuries by using nerve transfers; albeit to date, very few old reports have focused on the reconstruction of sensory loss resulting from upper trunk injuries. In this case series, we review six cases (five males and one female) with upper trunk brachial plexus injuries undergoing sensory nerve transfers. Methods Sensory reconstruction was carried out by using transfer of the ulnar to the median nerves, innervating adjacent aspects of the little and ring fingers (the fourth web space) and adjacent aspects of the thumb and the index finger (the first web space), respectively. Results The mean age of our six patients was 30.5 ± 9 years old (range 20–45). The mean time interval between the injury and subsequent surgery was 6.6 ± 1.8 months (range 5–10). Five patients achieved S3 or S3+ in both the thumb and the index finger while the sixth one regained S2+ in the index finger while also achieving S3 in the thumb according to the Highet–Zachary system scoring scale. Conclusion These results suggest that nerve transfers can achieve satisfactory outcomes in patients having sensory reconstruction after upper brachial plexus injuries, and thus, we lay emphasis on reviving the use of sensory nerve transfer techniques in such patients.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-018-3648-z