Neurotización del nervio circunflejo por vía axilar, estudio cadavérico

Objective

To confirm the technical feasibility of neurotization of the axillary nerve by the motor branch of the long head of the triceps in order to define the surgical anatomy of the radial and axillary nerves.

Materials and method

Twenty cadaver shoulders were operated on for transfer of the radial nerve branch for the long head of the triceps to the anterior branch of the axillary nerve by axillary approach. The correct choice of the receiving nerve was confirmed by posterior approach.

Results

An adequate dissection of the first motor branch of the radial nerve of the axillary nerve and of the anterior branch of the Axillary Nerve was achieved, The origin of the motor branch was found on average at 3.8 mm (+/−7.3 mm) distal to the superior border of the latissimus dorsi tendon. The axillary nerve was found 11.3 mm (+/−2.13 mm) cephalad to the upper border of the latissimus dorsi and 3.05 mm (+/−1.3 mm) distal to the teres minor. A tensionless coaptation was obtained in all cases.

Conclusion

Neurotization of the axillary nerve with the first branch of the radial nerve was successfully achieved through the axillary approach. This approach is adequate, avoiding position change to prone and double approach, and if additional reconstruction procedures are required at the same surgical time, Oberlin type and supraclavicular explorations of the brachial plexus can be performed without changing position.