Dorsal Scapular Nerve Transfer to Suprascapular Nerve

Abstract

Background: Obstetrical brachial plexus injury involving the suprascapular nerve is conventionally treated using an accessory nerve transfer or grafting. In circumstances where the accessory nerve is unsuitable, transfer of nerves with redundant function may be an alternate method of restoring function. Methods: This case describes the surgical technique of restoring shoulder function by reinnervating the musculature of the suprascapular nerve with a dorsal scapular nerve transfer in a patient with an obstetrical brachial plexus injury. Results: At 15 months post-operatively, the patient shoulder movement improved from zero muscle contraction to full range of motion against gravity measured by the active movement scale. His composite mallet score was 23 out of 25, with perfect scores in abduction and external rotation. Secondary surgery was not required. Conclusions: This case demonstrates a novel alternative to suprascapular nerve reinnervation in circumstances where the accessory nerve is unavailable, damaged, or otherwise suboptimal. Successful results were achieved, thus warranting consideration in clinical practice as well as further exploration and study.