Surgical outcome of phrenic nerve transfer to the anterior division of the upper trunk in treating brachial plexus avulsion.

Abstract

The purpose of this investigation was to study the surgical results of phrenic nerve transfer to the anterior division of the upper trunk of the brachial plexus. Between 2002 and 2005, 40 patients received a phrenic nerve transfer to the anterior division of the upper trunk of the brachial plexus to restore elbow flexion. These cases were followed postoperatively for > 2 years, and the efficacy of the surgery and related factors were evaluated. The overall effective rate of this procedure was 82.5% (Medical Research Council Grade >or= 3). The results show that for patients with surgical delay of > 1 year or prolongation of the latency of the preoperative phrenic nerve evoked potential > 20%, the recovery rates were 25 and 50%, respectively. Phrenic nerve transfer to the anterior division of the upper trunk of the brachial plexus is a simple procedure that causes minor surgical trauma and yields good recovery of elbow flexion. It is suitable in patients with a relatively intact structure at the division level of the brachial plexus.