Contralateral C7 transfer for the treatment of upper obstetrical brachial plexus palsy

Abstract

Purpose: The use of contralateral C7 is seldom indicated in infants with obstetrical brachial plexus palsy (OBPP). The purpose of this study was to evaluate the value of contralateral C7 transfer in infants with upper OBPP in order to define the application and outcome of this transfer in these infants more optimally.

Methods: Over a 5-year period, 15 infants with upper brachial plexus injuries underwent transfer of the contralateral C7 as part of the primary surgical reconstruction. The common trunk of the contralateral C7 root was transferred to the upper trunk or lateral cord on the affected side with nerve graft. The efficacy of the surgery and effects of patient age at the time of nerve transfer were analyzed.

Results: Patients were followed up for a mean duration of 46.8 months. Noteworthy function (≥M2+) was gained in 11 of 15 patients, and sensory function (≥S3, MRC grading system) was gained in all patients. Age was not the factor related to the outcome of this surgery.

Conclusions: Contralateral C7 transfer is an effective procedure for the restoration of upper limb function in infants with OBPP and root avulsions.