Hemi-CC7 Transfer Poor Option for Brachial Plexus Injury

Shoulder motor, median nerve function not regained following traumatic brachial plexus injury

MONDAY, Jan. 30 (HealthDay News) -- The use of hemi-contralateral C7 (CC7) transfer alone for either restoration of shoulder function or transfer to the median nerve is not recommended in patients with posttraumatic brachial plexus injury, according to a study published in the Jan. 18 issue of The Journal of Bone & Joint Surgery.

Douglas M. Sammer, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a retrospective review of patients with traumatic brachial plexus injury who underwent hemi-CC7 transfer for restoration of shoulder function or median nerve function, from 2001 to 2008. Complications were assessed in all patients, irrespective of the length of follow-up. The results of electrodiagnostic studies and modified British Medical Research Council motor grading were reviewed for 13 patients who underwent hemi-CC7 transfer to the shoulder and 15 who underwent transfer to the median nerve; all patients were followed for more than 27 months.

The researchers identified electromyographic evidence of reinnervation in 12 of the 13 patients in the shoulder group, but only three patients achieved M3 or greater shoulder abduction motor function. Electromyographic evidence of reinnervation was seen in three patients in the median nerve group, but none developed M3 or greater composite grip. All patients experienced donor-side sensory or motor changes that were mostly mild and transient; however, severe, permanent donor-side motor and sensory losses were sustained in one patient.

"The outcomes of hemi-CC7 transfer for restoration of shoulder motor function or median nerve function following posttraumatic brachial plexus injury do not justify the risk of donor-site morbidity, which includes possible permanent motor and sensory losses," the authors write.

One or more of the authors disclosed financial ties to an entity in the biomedical arena.

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