Modified C7 neurotization for the treatment of obstetrical brachial plexus palsy

Abstract

Contralateral C7 transfer is used rarely in infants with obstetrical brachial plexus palsy (OBPP). We aimed to determine the efficacy of contralateral C7 transfer to two different recipient nerves in infants with OBPP. Between 2001 and 2005, 9 infants with brachial plexus root avulsions underwent nerve reconstruction using a modified C7 neurotization technique. In this procedure, the contralateral C7 root was transferred to both the musculocutaneous nerve and the median nerve on the affected side. The strength of the biceps muscles increased to M3 or M4 in 7 patients and to M2 in 2 patients. The median nerve transfers led to regained motor function and strength of wrist and finger flexors with improvement to M3 or M4 in 5 patients. All patients showed notable gains of sensory function. Contralateral C7 transfer to two different recipient nerves is a feasible and efficient approach in infants with OBPP.