IP Indian Journal of Neurosciences


Neurotization in brachial plexus injury – A 3 year experience in tertiary government institution


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Author Details: Rajeev M.P., Premkumar Sasi, Pavitharan V.M., Pravin Yashwant Waykule

Volume : 4

Issue : 1

Online ISSN : 2581-916X

Print ISSN : 2581-8236

Article First Page : 18

Article End Page : 22


Abstract

Introduction: Brachial plexus injuries are devastating injuries which leaves patient with useless upper limb. Many poor patients with these injuries attending the government hospitals in the hope of treatment, but very few government hospitals are operating such patients. Neurotization is very effective treatment among all other methods.
Materials and Methods: This is retrospective study. Between February 2014 and May 2017, total 13 patients with brachial plexus injuries underwent neurotization in our department. Inclusion criterias were injuries to the upper spinal roots (C5, C6, C7), Surgery within 3 to 12months of injury and Minimum follow up period of 12 months. Neurotization procedures were used for shoulder included transfer of spinal accessory nerve to suprascapular nerve in 12 patients, Somsak procedure in 4 patients, for elbow included Oberlin 1 procedure in 6 patients, oberline 2 procedure in 5 patients, Intercostal nerves to musculocutaneous nerve in4 patients.
Results: Medical Research Council (MRC) scoring system was used to assess motor recovery. Results for shoulder and elbow function recovery seen as excellent in 1 (7.69%) and 3(23.07%), good in 1 (7.69%) and 4 (30.76%), fair in 5 (38.46%) and 6 (46.15%), poor in 6(46.15%) and 0 patients respectively.
Conclusions: Neurotization is a simple and elegant procedure. Young patients with short denervation time, intraplexal and direct nerve transfers close to the target muscle decides the good functional outcome.

Keywords
: Brachial plexus injury, Neurotization, Denervation time, Somsak and Oberline procedures.

 

Doi :-https://doi.org/10.18231/.2018.0005