Maria Hyttinen, Henrikki Rönkkö, Pasi Paavilainen, Mika Helminen, Jarkko Jokihaara
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Results of spinal accessory nerve to suprascapular nerve transfers in children with brachial plexus birth injury
Shoulder external rotation after brachial plexus birth injury can be restored by transfer of the spinal accessory nerve to the suprascapular nerve, or more distally to its infraspinatus branch. We studied the outcome of these nerve transfers in 52 patients with a minimum postoperative follow-up of 12 months (mean 7.3 years). The median postoperative improvement in shoulder external rotation was 120° (interquartile range [IQR] 45–135) after anterior and 110° (IQR 83–120) after dorsal spinal accessory nerve transfer to the suprascapular nerve main trunk, and 110° (IQR 80–125) after transfer to the infraspinatus branch. Patients operated after 20 months obtained external rotation ≥90° less frequently. The results of this study suggest that a decision about distal nerve transfer for shoulder external rotation is recommended at 1.5 years of age.Level of evidence: III
期刊介绍:
The Journal of Hand Surgery (European Volume) is essential reading for everyone involved in restoring the function to the hand and upper limb. Dedicated to the needs of hand, plastic, reconstructive and orthopaedic surgeons, it publishes the best selection of current papers on hand surgery.
The journal regularly highlights key developments in a range of original, authoritative and highly informative articles written by distinguished experts from around the world. Rapid coverage of the latest research, techniques, trends and ideas to make sure you stay up-to-date.
Subjects covered include:
joint replacement
fracture and joint injuries
microvascular surgery
congenital hand problems
You will also find editorials, book reviews, conference dates, case studies, detailed coverage of new techniques and full-length reviews articles.