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J Hand Surg Eur Vol. 2016 Oct;41(8):863-74. doi: 10.1177/1753193416638999. Epub 2016 Mar 17.

Recovery of upper extremity function following endoscopically assisted contralateral C7 transfer for obstetrical brachial plexus injury.

Author information

1
Department of Orthopaedic Surgery and Traumatology, Hacettepe University, Ankara, Turkey gurselleblebicioglu@ttmail.com.
2
Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
3
Department of Orthopaedic Surgery and Traumatology, Hacettepe University, Ankara, Turkey.
4
Acibadem Ankara Hospital, Ankara, Turkey.

Abstract

Transfer of the contralateral C7 nerve for reconstruction of the brachial plexus in infants with obstetrical brachial plexus injury has rarely been reported. We developed a new endoscopy-assisted technique via the prevertebral (retroesophageal) route for the transfer of the contralateral C7 nerve in reconstruction of the brachial plexus. The reconstruction was performed in 20 infants (14 boys and six girls). Motor recovery was assessed using the Gilbert and Raimondi scales. The Narakas Sensory Grading System was used to evaluate hand sensation. The mean follow-up period was 45 months (SD 18.2). Of the 20 children, nine had contralateral C7 transfer to lower nerve roots, two had transfer to upper nerve roots and nine had transfer to both upper and lower roots. The postoperative shoulder and elbow functions were good or satisfactory according to the Gilbert classification in all children whose preoperative scores were poor. All patients with lower roots reconstruction (9) had satisfactory hand function. A total of 15 children had a Narakas score of S3. Our technique enables safe contralateral C7 transfer to the avulsed roots in severe obstetrical brachial plexus injury infants with a satisfactory functional recovery.

LEVEL OF EVIDENCE:

Level IV.

KEYWORDS:

Obstetrical brachial plexus; contralateral C7; function; rehabilitation; surgery

PMID:
26988920
DOI:
10.1177/1753193416638999
[Indexed for MEDLINE]

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