Axillary nerve palsy

Nerve transfer has become a common and often effective reconstructive strategy for proximal and complex peripheral nerve injury of the upper limb. A case-based discussion explores the principles and potential benefits of nerve transfer surgery and offers in-depth discussion of several established and valuable techniques including: motor transfer for elbow flexion after musculocutaneous nerve injury, deltoid reanimation for axillary nerve palsy, intrinsic re-innervation following proximal ulnar nerve repair, and critical sensory recovery despite non-reconstructable median nerve lesions. 1).

2: Loch-Wilkinson T, McNeil S, White C, Schrag C, Midha R. Nerve Transfers in Patients with Brown-Séquard Pattern of Spinal Cord Injury: Report of 2 Cases. World Neurosurg. 2018 Feb;110:152-157. doi: 10.1016/j.wneu.2017.10.169. Epub 2017 Nov 10. PubMed PMID: 29129770.

3: Emamhadi M, Andalib S. The First Experience of Triple Nerve Transfer in Proximal Radial Nerve Palsy. World Neurosurg. 2018 Jan;109:351-355. doi: 10.1016/j.wneu.2017.10.033. Epub 2017 Oct 16. PubMed PMID: 29042331.

4: Yang X, Xu B, Tong JS, Zhang CG, Dong Z, Liu JB. Triceps motor branch transfer for isolated axillary nerve injury: Outcomes in 9 patients. Orthop Traumatol Surg Res. 2017 Dec;103(8):1283-1286. doi: 10.1016/j.otsr.2017.07.002. Epub 2017 Aug 1. PubMed PMID: 28778626.

5: Panchamia JK, Olsen DA, Sanchez-Sotelo J, Amundson AW. Combined Selective Nerve Blockade and Local Infiltration Analgesia in a Total Shoulder Arthroplasty Patient With Chronic Pain and Severe Restrictive Lung Disease: A Case Report. A A Case Rep. 2017 Dec 15;9(12):360-363. doi: 10.1213/XAA.0000000000000617. PubMed PMID: 28767480.

6: Ferré F, Cugnin N, Martin C, Marty P, Bonnevialle N, Kurrek M, Minville V. Regional Anesthesia With Noninvasive Ventilation for Shoulder Surgery in a Patient With Severe Chronic Obstructive Pulmonary Disease: A Case Report. A A Case Rep. 2017 May 15;8(10):261-264. doi: 10.1213/XAA.0000000000000488. PubMed PMID: 28252542.

7: Johnsen PH, Wolfe SW. Successful Nerve Transfers for Traumatic Brachial Plexus Palsy in a Septuagenarian: A Case Report. Hand (N Y). 2016 Dec;11(4):NP30-NP33. doi: 10.1177/1558944715627241. Epub 2016 Sep 9. PubMed PMID: 28149223; PubMed Central PMCID: PMC5256648.

8: Fleury M, Lepage D, Pluvy I, Pauchot J. [Nerve transfer between the intercostal nerves and the motor component of the musculocutaneous nerve. Anatomical study of feasibility]. Ann Chir Plast Esthet. 2017 Jun;62(3):255-260. doi: 10.1016/j.anplas.2016.11.004. Epub 2016 Dec 29. French. PubMed PMID: 28041767.

9: Tran DQ, Elgueta MF, Aliste J, Finlayson RJ. Diaphragm-Sparing Nerve Blocks for Shoulder Surgery. Reg Anesth Pain Med. 2017 Jan/Feb;42(1):32-38. doi: 10.1097/AAP.0000000000000529. Review. PubMed PMID: 27941477.

10: Goubier JN, Teboul F. Rhomboid nerve transfer to the suprascapular nerve for shoulder reanimation in brachial plexus palsy: A clinical report. Hand Surg Rehabil. 2016 Oct;35(5):363-366. doi: 10.1016/j.hansur.2016.07.002. Epub 2016 Sep 23. PubMed PMID: 27781982.

11: Ghanghurde BA, Mehta R, Ladkat KM, Raut BB, Thatte MR. Distal transfers as a primary treatment in obstetric brachial plexus palsy: a series of 20 cases. J Hand Surg Eur Vol. 2016 Oct;41(8):875-81. doi: 10.1177/1753193416663887. Epub 2016 Aug 18. PubMed PMID: 27543083.

12: Baltzer HL, Kircher MF, Spinner RJ, Bishop AT, Shin AY. A Comparison of Outcomes of Triceps Motor Branch-to-Axillary Nerve Transfer or Sural Nerve Interpositional Grafting for Isolated Axillary Nerve Injury. Plast Reconstr Surg. 2016 Aug;138(2):256e-64e. doi: 10.1097/PRS.0000000000002368. PubMed PMID: 27465187.

13: Chu B, Wang H, Chen L, Gu Y, Hu S. Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury. Ann Plast Surg. 2016 Jun;76(6):668-73. doi: 10.1097/SAP.0000000000000747. PubMed PMID: 26835823.

14: Sankaran R, Shah R, Menon S, Pillai A. Congenital subaxial cervical subluxation presenting as a bilateral Erb's palsy: surgical management, rehabilitation, and outcome. Childs Nerv Syst. 2016 May;32(5):849-55. doi: 10.1007/s00381-015-2946-5. Epub 2015 Nov 9. PubMed PMID: 26552384.

15: Fridén J, Gohritz A. Tetraplegia Management Update. J Hand Surg Am. 2015 Dec;40(12):2489-500. doi: 10.1016/j.jhsa.2015.06.003. Review. PubMed PMID: 26537454.

16: Baltzer HL, Spinner RJ, Bishop AT, Shin AY. Axillary Nerve Reconstruction: Anterior-Posterior Exposure With Sural Nerve Cable Graft Pull-Through Technique. Tech Hand Up Extrem Surg. 2015 Dec;19(4):168-75. doi: 10.1097/BTH.0000000000000103. Review. PubMed PMID: 26524659.

17: Goubier JN, Teboul F. Transfer of the rhomboid nerve to the suprascapular nerve: An anatomical feasibility study. Chir Main. 2015 Sep;34(4):182-5. doi: 10.1016/j.main.2015.05.003. Epub 2015 Jul 6. PubMed PMID: 26159580.

18: Chim H, Kircher MF, Spinner RJ, Bishop AT, Shin AY. Triceps motor branch transfer for isolated traumatic pediatric axillary nerve injuries. J Neurosurg Pediatr. 2015 Jan;15(1):107-11. doi: 10.3171/2014.9.PEDS14245. PubMed PMID: 25396703.

19: Bertelli JA, Ghizoni MF. Nerve transfers for elbow and finger extension reconstruction in midcervical spinal cord injuries. J Neurosurg. 2015 Jan;122(1):121-7. doi: 10.3171/2014.8.JNS14277. PubMed PMID: 25343189.

20: Zuckerman SL, Eli IM, Shah MN, Bradley N, Stutz CM, Park TS, Wellons JC 3rd. Radial to axillary nerve neurotization for brachial plexus injury in children: a combined case series. J Neurosurg Pediatr. 2014 Nov;14(5):518-26. doi: 10.3171/2014.7.PEDS13435. Epub 2014 Sep 5. PubMed PMID: 25192235.

21: Miyamoto H, Leechavengvongs S, Atik T, Facca S, Liverneaux P. Nerve transfer to the deltoid muscle using the nerve to the long head of the triceps with the da Vinci robot: six cases. J Reconstr Microsurg. 2014 Jul;30(6):375-80. doi: 10.1055/s-0033-1361927. Epub 2014 Jun 23. PubMed PMID: 24956484.

22: Wolfe SW, Johnsen PH, Lee SK, Feinberg JH. Long-nerve grafts and nerve transfers demonstrate comparable outcomes for axillary nerve injuries. J Hand Surg Am. 2014 Jul;39(7):1351-7. doi: 10.1016/j.jhsa.2014.02.032. Epub 2014 Apr 29. PubMed PMID: 24785698.

23: Bertelli JA, Ghizoni MF. Nerve transfer from triceps medial head and anconeus to deltoid for axillary nerve palsy. J Hand Surg Am. 2014 May;39(5):940-7. doi: 10.1016/j.jhsa.2014.01.005. Epub 2014 Feb 28. PubMed PMID: 24582845.

24: Silbermann-Hoffman O, Teboul F. Post-traumatic brachial plexus MRI in practice. Diagn Interv Imaging. 2013 Oct;94(10):925-43. doi: 10.1016/j.diii.2013.08.013. Epub 2013 Sep 12. Review. PubMed PMID: 24035438.

25: Haninec P, Mencl L, Kaiser R. End-to-side neurorrhaphy in brachial plexus reconstruction. J Neurosurg. 2013 Sep;119(3):689-94. doi: 10.3171/2013.6.JNS122211. Epub 2013 Jul 12. PubMed PMID: 23848824.

26: Oberlin C, Chino J, Belkheyar Z. Surgical treatment of brachial plexus posterior cord lesion: a combination of nerve and tendon transfers, about nine patients. Chir Main. 2013 Jun;32(3):141-6. doi: 10.1016/j.main.2013.04.002. Epub 2013 May 23. PubMed PMID: 23759287.

27: Bertelli JA, Ghizoni MF. Single-stage surgery combining nerve and tendon transfers for bilateral upper limb reconstruction in a tetraplegic patient: case report. J Hand Surg Am. 2013 Jul;38(7):1366-9. doi: 10.1016/j.jhsa.2013.03.056. Epub 2013 Jun 7. PubMed PMID: 23751324.

28: Haninec P, Mencl L, Bačinský P, Kaiser R. Serious axillary nerve injury caused by subscapular artery compression resulting from use of backpacks. J Neurol Surg A Cent Eur Neurosurg. 2013 Dec;74 Suppl 1:e225-8. doi: 10.1055/s-0033-1343987. Epub 2013 May 21. PubMed PMID: 23696291.

29: Miller JH, Garber ST, McCormick DE, Eskandari R, Walker ML, Rizk E, Tubbs RS, Wellons JC. Oberlin transfer and partial radial to axillary nerve neurotization to repair an explosive traumatic injury to the brachial plexus in a child: case report. Childs Nerv Syst. 2013 Nov;29(11):2105-9. doi: 10.1007/s00381-013-2131-7. Epub 2013 May 5. PubMed PMID: 23644630.

30: Kostas-Agnantis I, Korompilias A, Vekris M, Lykissas M, Gkiatas I, Mitsionis G, Beris A. Shoulder abduction and external rotation restoration with nerve transfer. Injury. 2013 Mar;44(3):299-304. doi: 10.1016/j.injury.2013.01.005. Epub 2013 Jan 18. Review. PubMed PMID: 23337704.

31: Crouch DL, Plate JF, Li Z, Saul KR. Biomechanical contributions of posterior deltoid and teres minor in the context of axillary nerve injury: a computational study. J Hand Surg Am. 2013 Feb;38(2):241-9. doi: 10.1016/j.jhsa.2012.11.007. Epub 2013 Jan 5. PubMed PMID: 23294649; PubMed Central PMCID: PMC3607282.

32: Teissier P, Lazerges C, Marès O, Bosch C, Chammas M. [Nerve transfer in isolated deltoid palsy: branch of the long head of the triceps to the axillary nerve]. Chir Main. 2012 Oct;31(5):239-43. doi: 10.1016/j.main.2012.08.007. Epub 2012 Sep 23. French. PubMed PMID: 23067683.

33: Domínguez-Páez M, Socolovsky M, Di Masi G, Arráez-Sánchez MÁ. [Isolated traumatic injuries of the axillary nerve. Radial nerve transfer in four cases and literatura review]. Neurocirugia (Astur). 2012 Nov;23(6):226-33. doi: 10.1016/j.neucir.2012.06.003. Epub 2012 Jul 31. Review. Spanish. PubMed PMID: 22858051.

34: Samardzić M, Rasulić L, Lakićević N, Bascarević V, Cvrkota I, Mićović M, Savić A. Collateral branches of the brachial plexus as donors in nerve transfers. Vojnosanit Pregl. 2012 Jul;69(7):594-603. PubMed PMID: 22838171.

35: Haninec P, Kaiser R. Axillary nerve repair by fascicle transfer from the ulnar or median nerve in upper brachial plexus palsy. J Neurosurg. 2012 Sep;117(3):610-4. doi: 10.3171/2012.5.JNS111572. Epub 2012 Jun 29. PubMed PMID: 22746376.

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70: Tomaino MM. Neurophysiologic and clinical outcome following medial pectoral to long thoracic nerve transfer for scapular winging: a case report. Microsurgery. 2002;22(6):254-7. PubMed PMID: 12375292.

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1)
Isaacs J, Cochran AR. Nerve transfers for peripheral nerve injury in the upper limb: a case-based review. Bone Joint J. 2019 Feb;101-B(2):124-131. doi: 10.1302/0301-620X.101B2.BJJ-2018-0839.R1. Review. PubMed PMID: 30700118.
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