Open AccessUse of intercostal nerves for different target neurotization in brachial plexus reconstruction
Author(s) -
Marios G. Lykissas,
Ioannis Kostas-Agnantis,
Ananstasios V Korompilias,
Marios D. Vekris,
Alexandros E. Beris
Publication year - 2013
Publication title -
world journal of orthopedics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.76
H-Index - 43
ISSN - 2218-5836
DOI - 10.5312/wjo.v4.i3.107
Subject(s) - intercostal nerves , medicine , brachial plexus , reinnervation , brachial plexus injury , palsy , anatomy , surgery , elbow , median nerve , anesthesia , alternative medicine , pathology
Intercostal nerve transfer is a valuable procedure in devastating plexopathies. Intercostal nerves are a very good choice for elbow flexion or extension and shoulder abduction when the intraplexus donor nerves are not available. The best results are obtained in obstetric brachial plexus palsy patients, when direct nerve transfer is performed within six months from the injury. Unlike the adult posttraumatic patients after median and ulnar nerve neurotization with intercostal nerves, almost all obstetric brachial plexus palsy patients achieve protective sensation in the hand and some of them achieve active wrist and finger flexion. Use in combination with proper muscles, intercostal nerve transfer can yield adequate power to the paretic upper limb. Reinnervation of native muscles (i.e., latissimus dorsi) should always be sought as they can successfully be transferred later on for further functional restoration.