Contrateral C₇ Transfer For Treatment Of Brachial Plexus Injuries

Objective: To explore the result of contralateral C7 transfer to treat the brachial plexus root avulsion injury and observe the affect on the sensory and motor function of the healthy limb. Methods 11 patients were treated with contralateral C7 transfer for brachial plexus root avulsion injuries from october ,2004, to september ,2006.Recipient nerve included median nerve in 5 cases ,radial nerve in 3 cases ,musculocutaneous nerve in 2 cases ,both median nerve and radial nerve in 2 cases ,and both median and musculocutaneous nerve in 1 case. Results followed-up time between 6 months to 23 months ,the mean time being 23 months.There was no impairment of healthy limb function .(1) 3 patients (3\5) of C7 to median nerve transfer demonstrated Wirst flexors reached≥M3 power in 3 patients (3\5),while finger flexors reached≥M3 power in 2 patients (3\5),S3 or better sensory recovery was seen in 3 patients (3\5)。(2) Both patients of C7 to musculocutanrous nerve transfer Elbow flexion strength was≥M3 and the sensation reached≥S3 in 1 patient (1\2).(3) For C7 to radial nerve transfer ,Wrist extensor power recovered to≥M3 in 2 patients (2\3) while finger extensor power was≥M3 in 1 patient (1\3).Sensation reached≥S3 in 2 patients (2\3).(4)Following simultaneous neurotization of both median and radial nerve ,wrist flexion was≥M3 in 2 patients (2\2) while finger flexion≥M3 in 1 patient (1\2).Median nerve sensory recovery of both cases reached S2 but radial nerve motor function was only M2 and M0 .Sensory recovery was as S1 .(5) The patient of simultaneous neurotization of both median and musculocutaneous nerves both elbow flexion and wrist flexion reached≥M3.Co-contracion was noted in 9 patient of this series .there was 2 patients (4\11) who could move their affected limbs independently .Conclusion Contralateral C7 transfer is an ideal procedure for the treatment of brachial plexus root avulsion injuries .When two nerves are to be neurolized simultaneously ,nerves of synergistic function should be combined .