Outcomes of Nerve Transfer Procedures for Shoulder Abduction in Traumatic Brachial Plexus Injuries: A Retrospective Study at Saraburi Hospital
Keywords:
Traumatic brachial plexus injury, Nerve transfer, Shoulder abduction, Retrospective study, Muscle strengthAbstract
Traumatic brachial plexus injuries cause severe functional loss, particularly in shoulder abduction, which is crucial for daily living. Nerve transfer is an established microsurgical technique that restores muscle function.
This retrospective study compared outcomes of two surgical techniques for irrecoverable upper trunk injuries (C5–C6): spinal accessory nerve to suprascapular nerve, and spinal accessory nerve to suprascapular nerve combined with nerve to the long head of the triceps muscle to anterior axillary nerve. Fifty-seven patients underwent surgery between October 2013 and October 2023, with 56 completing follow-up. Most injuries were traffic-related (87.7%). Assessment using the Medical Research Council (MRC) grading scale showed that the dual-transfer group achieved faster recovery (mean 10.08 vs. 13.14 months, p<0.05), though no statistically significant difference was found in the proportion achieving MRC grade ≥3 (p>0.05).
These findings indicate that both techniques effectively improve shoulder abduction, arm function, and quality of life, with dual transfer providing a faster recovery advantage. The results highlight the capacity of provincial hospitals to deliver high-level microsurgical care and contribute valuable evidence to comparative research on nerve transfer procedures within the Thai healthcare system.
Downloads
References
Bertelli JA, Ghizoni MF. Results and current approach for brachial plexus reconstruction. J Brachial Plex Peripher Nerve Inj. 2011;6(1):2. doi:10.1186/1749-7221-6-2
Colbert SH, Mackinnon SE. Nerve transfers for brachial plexus reconstruction. Hand Clin. 2008;24(4):341-61. doi:10.1016/j.hcl.2008.07.001
Dy CJ, Garg R, Lee SK, Tow P, Mancuso CA, Wolfe SW. A systematic review of outcomes reporting for brachial plexus reconstruction. J Hand Surg Am. 2015;40(2):308-13. doi:10.1016/j.jhsa.2014.10.03
Wang JP, Rancy SK, Lee SK, Feinberg JH, Wolfe SW. Shoulder and elbow recovery at 2 and 11 years following brachial plexus reconstruction. J Hand Surg Am. 2016;41(2):173-9. doi:10.1016/j.jhsa.2015.11.010
Huan KWSJ, Tan JSW, Tan SH, Teoh LC, Yong FC. Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve: a report of 13 cases. J Hand Surg Eur. 2017;42(7):700-5. doi:10.1177/1753193416680725
Ciesla N, Dinglas V, Fan E, Kho M, Kuramoto J, Needham D. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients. J Vis Exp. 2011;(50):e2632.
Nishijima N., Yamamuro T., Fujio K, Ohba M., The swallow-tail sign: a test of deltoid function. J Bone Joint Surg Br. 1995;77(1):152-3.
Leffert RD. Peripheral reconstruction of the upper limb following brachial plexus injury. In: Leffert RD, editor. Brachial plexus injuries. New York: Churchill Livingstone; 1985. p.189-235.
Samardzic M, Grujicic D, Antunovic V. Nerve transfer in brachial plexus traction injuries. J Neurosurg. 1992;76(2):191-7.
Narakas AO. Neurotization in the treatment of brachial plexus injuries. In: Gelberman RH, editor. Operative nerve repair and reconstruction. Philadelphia: JB Lippincott; 1991. p.1329-58.
Leechavengvongs S, Witoonchart K, Uerpairojkit C, Malungpaishorpe K, Wongnopsuwan V. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps. Part II: a report of 7 cases. J Hand Surg Am. 2003;28(4):633-8.
Merrell GA, Barrie KA, Katz DL, Wolfe SW. Results of nerve transfer techniques for restoration of shoulder and elbow function: a meta-analysis of the English literature. J Hand Surg Am. 2001;26(2):303-14.
Kim DH, Cho YJ, Tiel RL, Kline DG. Outcomes of surgery in 1019 brachial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg. 2003;98(5):1005-16.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Singburi Hospital Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The published articles are copyrighted by Singburi Hospital.
The statements appearing in each article in this academic journal are the personal opinions of each author and are not related in any way to Singburi Hospital or other hospital personnel. Each author is solely responsible for all contents of their article. If there are any errors, each author alone will be responsible for their own article.
