Long-term Results Of Intercostal Nerves Transfer To Triceps Branch Of Radial Nerve

Brachial plexus injury is a devastating injury to upper extremity. For brachial plexus injury, especially the total root avulsion injury, there are many functions need to be restore. Elbow extension is not the priority functions need to reconstruct, however, elbow extension is very important for elbow stability. It can develop the prehension of the injury extremity without help of the contralateral hand. As the technical developing, we have more donor nerves to repair more functions, such as elbow extension. In our institute, we usually use intercostal nerve transfer to triceps branch of radial nerve to restore elbow extension. In this article, we present patients who underwent this surgery in our institute, and outcomes were analyzed.Purposes:to explore long-term recovery of elbow extension after transferring intercostal nerve to triceps branch of radial nerve. Functional outcomes and multiple variables were analyzed and recorded.Methods:25patients with brachial plexus injury had intercostal nerves transferred to triceps branch of radial nerve at our hospital between2004and2008, their elbow extensions were studied retrospectively.17patients were total brachial plexus root avulsion while8patients were C5-C7root avulsion with traction of C8-T1. There were23men and2women, the mean patient’s age was25.3+8.5years, the mean denervation time was189.1±101.2days and the mean follow-up was48.6±15.4months.Results:good or excellent (M3+) of triceps motor recover were obtained in36.0%of patients,28%reached M2and36%reached M1or poor. Patients suffered C5-C7root avulsion with C8-T1traction has a better recover with62.5%reached M3+, compared with total brachial plexus root avulsion with23.5%, however, no statistical difference was observed. Using2intercostal nerves for neurotization got37.5%reached M3+, while using3nerves get33.3%, no statistical difference was observed. All the patients with nerve graft in surgery got poor results.Conclusion:intercostal nerve transfer to triceps branch of radial nerve can achieved adequate results.