Nerve graft and nerve transfer in traumatic brachial plexus injury

Bakr, Mostafa Sayed Mohammed; Hassan, Khaled Mohamed; Anani, Raafat Abd Ellatif; Ahmad, Mohammad-Reda

doi:10.21608/mjmr.2025.350642.1872

Nerve graft and nerve transfer in traumatic brachial plexus injury

Articles in Press

Document Type : Original Article

Authors

¹ Plastic, reconstructive and microsurgery, Faculty of medicine – Minia University

² Professor of Plastic and Hand surgery, Plastic Surgery Department, Faculty of Medicine, Minia University, Egypt

³ Plastic, reconstructive and microsurgery, Faculty of medicine – Zagazig University

10.21608/mjmr.2025.350642.1872

Abstract

Background:Treating brachial plexus injuries is challenging. Accurate localization of the injury through physical examination, imaging, and electrodiagnostic studies is essential for effective treatment.

The timing of repair is a key factor in determining the outcome. Early intervention within the first three months is widely agreed upon as beneficial, especially when recovery is unlikely without it.

Patients and methods:This retrospective and prospective clinical comparative non randomized study was helded in Plastic Surgery departments at Minia University Hospitals and at Zagazig University Hospitals on 40 patients (20 prospective and 20 retrospective). Patients were allocated into two groups according to type of procedure:

Group A: Patients previously were operated up on with nerve grafting.

Group B: Patients were operated up on with nerve transfers

Results: Regarding the comparison of Post operative outcome According to MRC between studied groups, the results were statistically significant (p value =0.007, 0.005 and 0.01 for Shoulder abduction, Shoulder flexion and Elbow flexion respectively) as shown in table 4

For shoulder abduction more than one half of cases had MRC 4 (55%) compared to 20% among cases of group I, while percentage of cases with MRC I and II were significantly higher in group I (5% and 45% respectively) than among cases of group II (0% and 5% respectively).

Conclusion:Our study stated that nerve transfer procedures more efficient than the traditional nerve grafting used in primary restoration of shoulder and elbow function after traumatic brachial plexus palsy.

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