Results on the treatment of C5, C6, ±C7 nerve root avulsion injuries with combined nerve transfers

Abstract

This study aims to evaluate the results of combined nerve transfers for restoration of elbow flexion, shoulder abduction and external rotation for 30 patients (29 males, 01 female) with the average age of 31.6 with C5, C6, ±C7 root avulsion of brachial plexus due to motor-bike accidents (100%). The mean time of preoperative delay was 3.9 months. 30 patients were treated with double nerve transfers for restoration of elbow flexion with the spinal accessory nerve to suprascapular nerve combined the long head of triceps to anterior branch of axillary nerve transfers for restoration of shoulder abduction and external rotation from July 2015 to October 2016. All patients were observed during the mean time of 31.8 months (range: 24 to 40 months). The average elbow flexion recovery was 11.0 kg lift: 24/30 patients had very good results, score ≥M4 (could lift ≥10 kg); 6/30 patients had good results, score M4 (could lift <10 kg). The average recovery shoulder abduction angle was 129.7°: 15/30 patients obtained very good results; 10/30, 1/30, and 4/30 patients got good, fair, and poor results, respectively. The mean value of recovery shoulder external rotation was 108.0°: 23/30 patients obtained very good results; 4/30 and 3/30 patients got good and poor results, respectively. Combined nerve transfers for restoration of elbow flexion, shoulder abduction and external rotation in upper brachial plexus injuries exhibited good results.