Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep 23;8(9):e3096.
doi: 10.1097/GOX.0000000000003096. eCollection 2020 Sep.

Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review

Matthew E Wells  1   2 , Gilberto A Gonzalez  2 , Benjamin R Childs  1   2 , Matthew R Williams  1 , Leon J Nesti  3   4 , John C Dunn  2   4
Affiliations

Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review

Matthew E Wells et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Brachial plexus and axillary nerve injuries often result in paralysis of the deltoid muscle. This can be functionally debilitating for patients and have a negative impact on their activities of daily living. In these settings, transferring the branch of the radial nerve innervating the triceps to the axillary nerve is a viable treatment option. Additional nerve transfers may be warranted. This study sought to determine the efficacy of nerve transfer procedures in the setting of brachial plexus and axillary nerve injuries and factors affecting clinical outcomes.

Methods: The U.S. National Library of Medicine's website "PubMed" was queried for "radial to axillary nerve transfer" and "brachial plexus nerve transfer." An initial review by two authors was performed to identify relevant articles followed by a third author validation utilizing inclusion and exclusion criteria. Individual patient outcomes were recorded and pooled for final analysis.

Results: Of the 80 patients, 66 (82.5%) had clinical improvement after surgical nerve transfer procedures. Significant difference in clinical improvement following nerve transfer procedures was correlated with patient age, mechanism of injury, brachial plexus vs isolated axillary nerve injuries, multiple nerve transfers vs single nerve transfers, and surgery within the first 7 months of injury. The branch of the radial nerve supplying the triceps long head showed improved clinical results compared with the branch of the radial nerve supplying the triceps medial head and anconeus.

Conclusion: Nerve transfers have been shown to be effective in restoring shoulder abduction in both isolated axillary nerve injuries and brachial plexus injuries.

PubMed Disclaimer

Conflict of interest statement

Disclosure: Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, and patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

Figures

Fig. 1.
Fig. 1.
Flow diagram of study selection and stages of exclusion.
Fig. 2.
Fig. 2.
Muscle strength grading and clinical evaluation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Bertelli JA, Ghizoni MF.Transfer of the accessory nerve to the suprascapular nerve in brachial plexus reconstruction. J Hand Surg Am. 2007;32:989. - PubMed
    1. Alnot JY.[Paralytic shoulder secondary to post-traumatic peripheral nerve lesions in the adult]. Acta Orthop Belg. 1999;65:10–22. - PubMed
    1. Bentolila V, Nizard R, Bizot P, et al. Complete traumatic brachial plexus palsy. Treatment and outcome after repair. J Bone Joint Surg Am. 1999;81:20–28. - PubMed
    1. Azze RJ, Mattar Júnior J, Ferreira MC, et al. Extraplexual neurotization of brachial plexus. Microsurgery. 1994;15:28–32. - PubMed
    1. Terzis JK, Kostas I, Soucacos PN.Restoration of shoulder function with nerve transfers in traumatic brachial plexus palsy patients. Microsurgery. 2006;26:316–324. - PubMed