Partial Radial Nerve Transfer to the Axillary Nerve for Reconstruction of Shoulder Abduction

Abstract

Background Data: In cases of axillary nerve injury, surgical reconstruction is indicated when no spontaneous recovery is noted after three to six months. Surgical repair has been carried out by neurolysis, a nerve graft or nerve transfer. Purpose: The aim of this study was to report our results with reconstruction of the axillary nerve by transferring the branch of the triceps lower medial head to the anterior division of the axillary nerve. Study Design: A descriptive analytic cross section retrospective study. Patients and Methods: The authors retrospectively reviewed their data archive from 2011 through 2015, and seven patients who were operated on due to complete injury of the axillary nerve either isolated or as part of brachial plexus injury were enrolled in the study. All patients underwent surgical reconstruction by transfer the radial nerve branch from the triceps medial head to the anterior division of the axillary nerve. Results: There were six men and one woman included in this study, with a mean age of 26 years (range 17–37 years). All patients recovered deltoid function and maintained full active elbow extension. Abduction strength improved from approximately 40% that of the normal side at 90˚ of abduction preoperatively to 60% of normal strength postoperatively. There was improved endurance in abduction from approximately 25% to 65% that of the normal side, which was sufficient to eliminate shoulder pain or fatigability. Conclusion: Transfer of the radial nerve branch for the lower triceps medial head to the anterior division of the axillary nerve proved to be an effective method of deltoid re-innervation. (2015ESJ101)