Video-assisted thoracoscopic surgery (VATS) aided full-length phrenic nerve transfer for restoration of elbow flexion
Document Type
Article
Publication Date
5-1-2023
Abstract
BackgroundIn complete brachial plexus injury, phrenic nerve (PN) is frequently used in neurotization for elbow flexion restoration. The advancement in video-assisted thoracoscopic surgery (VATS) allows full-length PN dissection intrathoracically for direct coaptation to recipient without nerve graft.PurposeWe report our experience in improving the surgical technique and its outcome.MethodsSeven patients underwent PN dissection via VATS and full-length transfer to musculocutaneous nerve (MCN) or motor branch of biceps (MBB) from June 2015 to June 2018. Comparisons were made with similar group of patients who underwent conventional PN transfer.ResultsMean age of patients was 21.9 years. All were males involved in motorcycle accidents who sustained complete brachial plexus injury. We found the elbow flexion recovery were earlier in full-length PN transfer. However, there was no statistically significant difference in elbow flexion strength at 3 years post-surgery.ConclusionWe propose full-length PN transfer for restoration of elbow flexion in patients with delayed presentation.
Keywords
thoracoscopic surgery, phrenic nerve transfer, neurotization, brachial plexus injury
Divisions
ortho,surgerydept
Publication Title
Journal of Orthopaedic Surgery
Volume
31
Issue
2
Publisher
SAGE Publications
Publisher Location
1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND