Brachial plexus injury in adult: Comparative effectiveness of anterior and posterior approach for shoulder function
Dr. Hiren Rana, Dr. Saleshkumar Soni, Dr. Manav Suri, Dr. Jayesh Sachde, Dr. MF Shaikh
Restoration of shoulder function is one of the most critical goals of treatment of brachial plexus injuries. Primary repair or nerve grafting of avulsion injuries of the upper brachial plexus in adults often leads to poor recovery. As our knowledge of shoulder neuromuscular anatomy and physiology improves and our experience with nerve transfers increases, so evolve the specific transfer procedures. This article presents a technique and rationale for reconstructing shoulder function by transferring the distal spinal accessory nerve to the suprascapular nerve through a posterior approach in 15 patients and anterior approach in 15 patients of different type of brachial plexus injury. Many different nerves have been utilized as donor nerves for transfer to the suprascapular nerve and axillary nerve for return of shoulder function with variable results. After identification of spinal accessory nerve on the anterior surface of trapezius and suprascapular nerve in suprascapular notch through posterior approach, trapezius function is preserved.
Dr. Hiren Rana, Dr. Saleshkumar Soni, Dr. Manav Suri, Dr. Jayesh Sachde, Dr. MF Shaikh. Brachial plexus injury in adult: Comparative effectiveness of anterior and posterior approach for shoulder function. International Journal of Medical and Health Research, Volume 3, Issue 9, 2017, Pages 36-39