Abstract
A successful reconstruction for brachial plexus injury requires the accurate diagnosis of the injury level through physical examination, neurological and imaging interpretation, the logical design for donor/recipient nerves based on anatomy and function, and meticulous microsurgical technique.
This case illustrates the one-stage nerve-based reconstruction in a 19-year-old male with right side traumatic complete palsy of C5-T1. Given that the patient had no function recovery after 2 months of rehabilitation, surgery was indicated. Due to the total palsy status lacking the available intraplexus neurotizers, the contralateral C7 served as donor for the median nerve with a vascularized ulnar nerve graft; the ipsilateral phrenic nerve served as donor for the suprascapular nerve, and the ipsilateral T3-T5 intercostal nerves served as donor for the musculocutaneous nerve.
At postoperative 39 months, the patient had achieved 110 degrees of shoulder abduction, elbow and finger flexion both improved to M4 power, and hand grip strength was 2 kilogram-weight; also the protective hand sensation was achieved, and the autonomic function was better. This one-stage surgery can successfully restore the basic function of the injury limb.
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Chen, L.WY., Wang, A., Lin, YC., Sung, C.WH., Chang, T.NJ. (2022). Brachial Plexus Secondary Reconstruction with Contralateral C7. In: Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-94191-2_60-1
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DOI: https://doi.org/10.1007/978-3-319-94191-2_60-1
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