A clinical study of spinal accessory nerve transfer for the repair of suprascapular nerve to restore the impaired abduction function of the shoulder following avulsion injury of the brachial plexus

Objective To observe the results of restoration of shoulder abduction by spinal accessory nerve transfer which was sectioned infraclavicularly to repair the suprascapular nerve in avulsed brachial plexus injury. Methods The donor nerve of accessory nerve was sectioned at the level of medial and lateral muscular branch entering the trapezius; the proximal segment was used for the transfer to repair the suprascapular nerve. The function of shoulder abduction was followed-up for 2-4 years in 49 patients with avulsed brachial plexus injury, the function of the trapezius after operation was also measured by physical check up and electrophysiological detection in 20 patients. Results The average range of the shoulder abduction was 61° , the muscle strength of the trapezius was unaffected on the upper and middle parts except the lower parts after the operation. Conclusion The shoulder function of the patients with brachial plexus injury recovered satisfactorily after transfer of the accessory nerve sectioned infraclavicularly to repair the suprascapular nerve; the muscle strength of the trapezius was unaffected on its upper and middle portion.