Full-Length Ulnar Nerve Harvest by Means of Endoscopy for Contralateral C7 Nerve Root Transfer in the Treatment of Brachial Plexus Injuries

Abstract

To avoid long scar formation after contralateral C7 transfer for treatment of brachial plexus avulsion injuries, endoscopy was used for full-length harvest of the ulnar nerve. The surgical procedure and its clinical effect are reported here. From July to August of 2001, two patients with total root avulsion were recruited. Three 2- to 3-cm-long incisions were made in the mid upper arm, elbow, and wrist, and the full-length ulnar nerve was harvested using the Endoscope Vessel Harvest System endoscope system. The surgical time was recorded, the vascularity of the dissected ulnar nerves was observed, and the recovery of the injured limb after contralateral C7 nerve root transfer was measured. Compared with the traditional technique, there were no significant differences in surgical time, vascularity of the dissected ulnar nerve, or recovery of the injured limb when the full-length ulnar nerve was harvested with endoscopy (as part of the contralateral C7 nerve root transfer operation), but the degree of scarring after surgery was markedly reduced. Although the same level of curative effect was ensured, the new endoscope-aided method for harvesting the full length of the ulnar nerve for contralateral C7 nerve root transfer was not complicated and caused markedly less scarring.