Abstract
There is no financial information to disclose. We aimed to critically evaluate our results of patients with traumatic brachial plexus injury who underwent either C5 or C6 root grafting or spinal accessory nerve transfer to suprascapular nerve transfer. A review was performed on all patients who underwent suprascapular nerve reconstructions for traumatic brachial plexus injury between 2001 to 2011. Exclusion criteria were any patients below the age of 18 and follow-up less than one year. Eighty-seven patients were identified and made the cohort of the study (36 grafting, 51 transfers). Mean age was 32 (range: 18-65) with 74 males and 13 females. There were 12 upper trunk (UT), 38 upper trunk with C7 (UT+7), and 37 complete brachial plexus injuries in our study population with mean time to surgery of 5.2 months (range: 0.8-11 months) and mean follow-up of 2.8 years (range 1-9.9 years). Eighteen percent were smokers, and mean BMI was 28 (range: 19-46). Nerve transfers were found to be statistically superior to nerve grafting for recovering MRC > 3 for external rotation. External rotation ROM was 10.9 degrees for transfers versus 2 degrees for grafting (P = 003). No significant difference in VAS or DASH scores was found favoring a particular method of reconstruction but EMG recovery favored the nerve transfer group. Additionally, age, BMI, smoking, time to surgery, length of graft, and type of graft were not found to affect strength or motor recovery for either groups. •Best clinical results for improved shoulder muscle grade (MRC > 3), shoulder range of motion, and EMG signs of recovery were obtained in patients who underwent spinal accessory nerve to suprascapular nerve transfer.•No significance found for DASH or VAS scores, age, BMI, smoking, time to surgery, length of graft, and type of graft for either transfers or grafting.
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