Clinical Results Of Intercostal And Phrenic Nerve Transfer In The Brachial Plexus Root Avulsion Injuries

Objective: To observe the treatment outcomes of brachial plexus root avulsion injuries by transferring phrenic nerve to the anterior division of the upper trunk of brachial plexus and intercostal nerve to the musculocutaneous nerve. Methods: From January 2009 to September 2014,20 case of brachial plexus root avulsion injuries were treated with the above two kinds of operation methods to restore elbow flexion at our hospital,among them 9 were treated with phrenic nerve transfer to the anterior division of the upper trunk of brachial plexus(phrenic nerve transfer group),11 were treated with intercostal nerve to the musculocutaneous nerve(intercostal nerve transfer group),postoperative follow-up ranged from 15 to 36 months with an average of 24.4 months. The operation index of two groups such as blood loss,operation time and incision length were reviewed.Muscle power of the biceps and angle of elbow flexion were evaluated. The function of musculocutaneous nerve was evaluated according to the probation criterions established by The Hand Surgery Insthute of Chinese Medical Association,and its good rate were calculated,and evaluate the treatment outcomes. Results: In phrenic nerve transfer group the length of operation incision and the operation time were short,and the blood loss was relatively little.Good or excellent recovery was 66.7% in the phrenic nerve transfer group,and 63.6% in the intercostal nerve transfer group,there is no statistically difference in two groups(P>0.05). Conclusion: Two kinds of the operation methods have good outcome for brachial plexus root avulsion injuries,and are effective procedure for elbow flexion restoration. phrenic nerve transfer has advantages in operation incision,blood loss and operation time,and it can be advocated for clinical treatment.