The mid-term effect observation of elbow flexion after root avulsion of the brachial plexus restored by nerve transposition

Objective To observe the effects of elbow function reconstruction after root avulsion of the brachial plexus by different nerves transferring to musculocutaneous nerve.Methods 12 patients with root avulsion of the brachial plexus including the upper trunk avulsion of brachial plexus in 8 cases and total brachial plexus root avulsion in 4 cases were treated by different nerves transferring to musculocutaneous nerve in order to reconstruct the elbow function after brachial plexus injury in our hospital from June 2006 to December 2012.All cases were followed up with the time ranging from 32 to 78 months after surgeries,and the mid-term effects were evaluated.Results The flexion functions of affected elbow joint in 12 patients were all restored in different degrees.The active contraction of the biceps and active elbow flexion were first appeared in phrenic nerve transposition.After reexamination,the excellent and good rates in both full recovery of Ⅳ grade above of muscle strength in elbow function and over 60° range of motion and evaluation of functional status were 75%.Conclusion Application of phrenic nerve transferring to musculocutaneous nerve in the reconstruction of elbow function after the root avulsion of the brachial plexus is better than other nerve transpositions.