Long-term results of intercostal nerve transfer to triceps branch of the radial nerve

Abstract

Objective To evaluate the long-term outcomes of restoring elbow extension by transferring intercostal nerves to the triceps branch of the radial nerve. Methods A retrospective study of 23 cases of brachial plexus injuries treated with intercostal nerve transfer to the triceps branch of the radial nerve at our hospital between 2004 and 2008 was conducted. Recovery of triceps muscle power and elbow extension was analyzed. Among these patients 16 had complete brachial plexus root avulsions while 7 had C5 to C7 root avulsions with lower tnmk non-avulsion lesions. The mean duration between injury and intercostal nerve transfer was 5.7 months. The mean follow-up time was 48.7 months. Results Good or excellent motor recovery of the triceps （muscle power over M3） was achieved in 39.1% of the patients. Triceps strength recovered to M2 in 30.4% of the patients and to M1 or lower in 30.5% of the patients. Patients with C5 to C7 root avulsion along with C,s to TI traction had better recovery than those with complete brachial plexus root avulsions. There was no significant difference in treatment outcomes when 2 or more than 2 intercostal nerves were used for neurotization. Conclusion Intercostal nerves transfer to the triceps branch of the radial nerve can restore triceps function to ~me extent. Key words: Brachial plexus; Intercostal nerve; Follow-up studies; Triceps branch; Nervetransfer