Nerve Transfers to Restore Shoulder and Elbow Functions in Upper Brachial Plexus (C5-C6) Injury— A Technical Note

Abstract

Brachial plexus injury is very commonly associated with road traffic accidents, especially motorcycle accidents, and frequently affects young adults, causing significant disability and impact on quality of life. These are devastating injuries leading to socioeconomic loss of not only the individual but also of the society and account for 10–20% of traumatic peripheral nerve injuries. In the past decade, nerve transfers have become the mainstay of the treatment in upper brachial plexus injuries. Brachial plexus surgeon has many options in his armamentarium to have increased functional outcome and his / her choices are dependent upon evaluation of the overall severity of the injury, available literature and personal experience and expertize with various surgical techniques. The priorities in the adult brachial plexus injury reconstruction are return of elbow function followed by shoulder recovery and stabilization. C5.6 injuries have a better prognosis with chances of recovery of shoulder and elbow function in the range of 85–90%, using these distal transfers, which have revolutionized the field of brachial plexus surgery.