Axillary to Radial Nerve Transfer for Elbow Extension in the Tetraplegic Patient: A Case Series.
Axillary-to-radial nerve transfer achieved functional elbow extension in most treated limbs.
Axillary to Radial Nerve Transfer for Elbow Extension in the Tetraplegic Patient: A Case Series.
Recovery of upper extremity function is considered the top priority in the tetraplegic population.
An anterior, transaxillary approach for transfer of select branches of the axillary nerve to the long head triceps branch of the radial nerve was performed on adult traumatic spinal cord injury patients.
at least antigravity elbow extension strength returned in most limbs
The median time from injury to surgery was 10 months.
Primary outcome was Medical Research Council strength grade 3 (2-4) with illustrative videos of each outcome.
The axillary to radial nerve transfer provided at least M3 strength in 13 of 22 (59%) limbs. An additional 4 limbs achieved M2, providing functional benefit to the patient.
Patients with a preoperative International Classification of Hand Surgery in Tetraplegia score of 3 or 4 all achieved antigravity strength overhead. No functional deficits due to donor nerve sacrifice was observed.
Further investigation will be necessary to establish predictive factors for success of patients with International Classification of Hand Surgery in Tetraplegia scores 1 and 2.
Overall, the axillary to radial nerve transfer is a good option for recovery of triceps function.