Transferência de nervos (neurotizações) no tratamento das lesões traumáticas do plexo braquial

Abstract

Brachial plexus avulsion injuries are usually caused by car and motorcycle accidents. Their consequences are devastating and represent a challenge to the surgeons who assist these patients. Positive results of this procedure depend on the interval between the injury and the definitive treatment. The treatment of brachial plexus avulsion injuries invariably involves the use of neurolysis, direct nerve repair, nerve grafts, and neurotization procedures. Several nerves have been used as donors in neurotizations. In general, there are two types of donor: extraplexal (intercostal, spinal accessory, and phrenic nerves, motor branches of the cervical plexus, and contralateral C7 root) and intraplexal (proximal spinal nerve stumps or collateral motor branches of the preserved brachial plexus). In fact, the intraplexal neurotization represents the classical form of nerve transfers.