Clinical application and early outcome of transfer of phrenic nerve in treatment of brachial plexus avulsion injuries

Objective To investigate clinical application of phrenic nerve transfer for restoration of elbow flexion in treatment of brachial plexus avulsion injueries and to analyze its early treatment outcome.Methods Transfer of phrenic nerve was done for treatment of brachial nerve root avulsion injuries in 8 cases.Direct anastomosis was carried out in 5 cases between phrenic nerve and anterior division of upper trunk in brachial plexus.Nerve anastomosis was done in 3 cases through nerve transfer between phrenic nerve and muslocutaneous nerve. The function of elbow flexion was assessed through the postoperative follow-up.Results According to 10 months to 2 years follow-up in 8 cases, the muscle tone in biceps brachial muscles obtained 2 grades and above in 5 cases,with 62.5% in effective rate.Conclusion Phrenic nerve transfer was an ideal procedure for treatment of brachial plexus root avulsion injuries. The key point of improvement of treatment outcome was the assessment of phrenic nerve function between preoperative and postoperative period,of rational selection of anastomic methods in nerve transfer,and of comprehensive postoperative rehabilitation.