Clinical Outcome Of Nerve Transfer For Treating Axillary Nerve Injury

Introduction:With the development of society, the brachial plexus injury becomes a common injury in clinic. It often combines with the injury of axillary nerve and causes the paralysis of the deltoid and dysfunction of patients’shoulder abduction. The nerve transfer is the main treatment of axillary nerve injury. We followed up clinical outcome of16patients with axillary nerve injury, to evaluate the long-term results of nerve transfer for treating axillary nerve injury and summarize the surgical indications and influencing factors.Objective:To evaluate the long-term results of nerve transfer for treating axillary nerve injury, and summarize the surgical indications and influencing factors.Method:From2000to2009, we collected16patient with axillary nerve injury who accepted the nerve transfer in Huashan hospital. All patients were male.8patients were affected in their left side,8right side. The ages ranged from16years old to54years old,30.8±11.3averagely. The donor nerves involved intercostal nerve and the nerve to the long head of the triceps. The follow-up time ranged from15months to112months,49.5±30.4averagely. The follow-up content included:(1) Elcetromyogram of the patients’ deltoid muscle and shoulder abduction after surgery;(2) Influencing factors of surgery such as age, follow-up time, injury type, donor nerve, etc. We also compared the shoulder abduction with another30patients who only underwent the nerve transfer for treating suprascapular nerve injury in Huashan hospital.Results:16patients’ shoulder abduction after surgery ranged from0～90°,52.6±32.1°averagely.56.2%patients achieved the good or excellent result after surgery,70%among patients who were younger than30and37.5%among patients who were older than30,75%among patients who underwent surgery in6months after injury and0%in more than1year group. The average shoulder abduction was36.2±29.5°in intercostal nerve group,73.6±22.5°in triceps group,34.7±25.3°in suprascapular nerve group.Conclusion:We advocated that patients with axillary nerve injury should get surgery in6months after injury. Repairing suprascapular nerve combined with axillary nerve could achieve better outcome of shoulder function. The nerve to the long head of the triceps was the first choice for donor. But the intercostal nerve was also a good choice when the nerve to the long head of the triceps was injuried.