Transferring intercostal nerves to the anterior branch of axillary nerve through a posterior approach

Abstract

Objective To provide anatomical evidence for restoring the deltoid function by trans- ferring 2 intercostal nerves to the anterior branch of the axillary nerve through a posterior approach. Methods Fifteen adult human cadavers embalmed by formalin were used.Microsursical longitudinal con- tradissection of the axillary nerves by tracing their terminal braches was conducted.The lengths of the 3rd, 4tth,5th and 6th intercostal nerves from tlle costochondral junction to the midaxillary line were recorded.The distance from the pivot point at the midaxillary line to the anterior branch of the axillary nerve was recorded as the tunnel length.Results The axillary nerve to the deltoid muscle is divided into 2 branches mostly. The anterior branch of the axillary nerve innervates about 4/5 of the dehoid muscle.The distancos from the costochondral junctions of the 3rd,4th,5th and 6th intercostal nerves to the pivot points average 11.41± O.35 cm,15.8l±1.12 cm,16.54±1.18 cm and 16.85±0.90 cm,respectively.The tunnel distances of the 3rd,4th,5th and 6th intercostal nerves average 11.53±0.47 cm,12.24±0.65 cm,13.22±1.15 cm and 13.82±1.02 cm,respectively. Conclusion Transfer of any two of the 4th,5th and 6th(except the 3rd)intercostal nerves to the anterior branch of the axillary nerve through a posterior approach call be an al- temative method for reconstruction of the deltoid muscle. Key words: Intercostal nerve; Nerve transfer; Anterior branch of axillary nerve