Semin Plast Surg 2005; 19(1): 66-74
DOI: 10.1055/s-2005-867109
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

Intercostal Nerve Neurotization for the Treatment of Obstetrical Brachial Plexus Palsy Patients

Julia K. Terzis1 , Ioannis Kostas2
  • 1Division of Plastic and Reconstructive Surgery, Eastern Virginia Medical School and International Institute of Reconstructive Microsurgery, Norfolk, Virginia
  • 2Microsurgery Program, Eastern Virginia Medical School, Norfolk, Virginia
Further Information

Publication History

Publication Date:
04 April 2005 (online)

ABSTRACT

In severe obstetrical brachial plexus palsy with proximal nerve root involvement, there is an insufficient number of motor axons to reconstruct the entire plexus, and neurotization procedures are the only possibility to achieve useful upper extremity function. One of the most useful neurotization procedures is intercostal nerve transfer. In our practice, intercostal nerve transfer was used for direct neurotization of primary nerve targets or for neurotization of transferred muscles. The best results were seen after intercostal nerve transfer to musculocutaneous nerve and triceps branch. Unlike adult posttraumatic brachial plexus patients, neurotization of the ulnar and median nerves in obstetrical brachial plexus palsy patients will result in protective sensation in almost all patients, and if used early enough, postinjury active wrist and finger flexion is possible.

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Julia K TerzisM.D. Ph.D. 

Microsurgical Research Center

P.O. Box 1980, 700 Olney Road, Norfolk, VA 23510

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