Clinical investigation of contrala teral C_7root transfer to the radial nerve for total brachial plexus root avulsion injury

Objective To observe the effect of contralateral C 7 root transfer to the radial nerve for the treatment of total brachial plexus root avulsion injury.Methods One hundred and seven patients with total brachial plexus root avulsion injury were treated by contralatera l C 7 root transfer to the radial nerve fro m1993to 1999.Among them 36patients were followed-up for more than 2years;there were 31male and 5female patients,with age ranged fro m 7to 44years,and 27years in average.The time of initial surgery from the time of injury was between 3to 36months,among which 4patients were tr eated between 3to 6months,29between 6to 12months,2between 12to24months and 1between 24to 36months;9.4months on the average.The whole surgical procedure was divided into three phases.Phase I:The exploration of the brachial plexus both above and below the clavicle;the phrenic nerve was transferr ed to the anterior branch of the su-perior trunk or was anastomosed with the musculocutaneous nerve;the accessory nerve was transferred to the supraclavicular nerve;the median nerve was previously placed subcutaneously at the anterior re gion of the arm-pit.PhaseⅡ:The contralateral C 7 nerve root was transferred to the uln ar nerve which was used for the bridging.PhaseⅢ:The intercostal nerve was transferred to the median nerve and the thorac odorsal nerve,the ulnar nerve and the radial nerve was a nastomosed.Patients were followed-up for 24months to 84months,38months on average.The follow-up sta ndards included:the recovery of the motor function of the muscles in-nervated by the radial nerve;the rec overy of the regeneration potential of the muscles;the change in the sensory function in the cutaneous re gion innervated by the radial nerve.Results Twenty-nine patients(80.6%of all)was improved in motor function,and 27patients(75.0%)in sensory function.Conclusion The overall effect of contralateral C 7 root transfer to the radial nerve for total brachial plexus root avulsion injury was satisfactory,while the functio nal recovery of triceps was not as exp ected.[