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. 2009 Jun;4(2):123-8.
doi: 10.1007/s11552-008-9136-9. Epub 2008 Oct 9.

Nerve transfer for elbow flexion in radiation-induced brachial plexopathy: a case report

Thomas H Tung  1 , Daniel Z Liu, Susan E Mackinnon
Affiliations

Nerve transfer for elbow flexion in radiation-induced brachial plexopathy: a case report

Thomas H Tung et al. Hand (N Y). 2009 Jun.

Abstract

Radiation-induced brachial plexopathy is an uncommon but devastating late complication seen in patients receiving radiation therapy to the chest wall and axilla. Treatment options are unfortunately limited. We report a case of a 59-year-old woman treated with radiation therapy for breast cancer 12 years earlier, who presented with loss of elbow flexion and marked shoulder weakness. Electromyogram and intraoperative stimulation of the musculocutaneous nerve branches were consistent with a proximal motor nerve conduction block. Microsurgical transfer of median and ulnar nerve fascicles to the biceps and brachialis branches of the musculocutaneous nerve, respectively, were performed. The patient recovered MRC grade 4/5 elbow flexion after surgery. The characteristics of this disorder and surgical treatment options are reviewed.

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Figures

Figure 1
Figure 1
Intraoperative dissection of biceps (A), LABC (B), and brachialis (C) branches of the musculocutaneous nerve.
Figure 2
Figure 2
Transfer of FDS fascicle of median nerve to biceps branch (A) and FCU fascicle of ulnar nerve to brachialis branch (B) of the musculocutaneous nerve.
See this image and copyright information in PMC

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