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
. 2021 Jul 1;41(6):374-378.
doi: 10.1097/BPO.0000000000001774.

Long Thoracic Nerve Transfer for Children With Brachial Plexus Injuries

Chase Kluemper  1 , Mike Aversano  2 , Scott Kozin  2 , Dan A Zlotolow  1   2
Affiliations

Long Thoracic Nerve Transfer for Children With Brachial Plexus Injuries

Chase Kluemper et al. J Pediatr Orthop. .

Abstract

Introduction: The transfer of intraplexal and extraplexal nerves for restoration of function in children with traumatic and birth brachial plexus palsies has become well accepted. Little has been written about using the long thoracic nerve (LTN) as a donor in reanimation of the upper extremity. The authors present a case series of nerve transfers using the LTN as a donor in brachial plexus injury.

Methods: A retrospective chart review was performed over a 10-year period at a single institution. The primary outcome measure was the active movement scale.

Results: Fourteen patients were included in the study: 10 birth injury patients and 4 blunt trauma patients. Average follow-up time was 21.3 and 10.75 months, respectively. The best outcomes were seen when the LTN was used for reinnervation of the obturator nerve in free functioning muscle transfers. The next most successful recipients were the musculocutaneous and axillary nerves. Outcomes were poor in transfers to the posterior interosseous fascicles of the radial nerve and the radial nerve branches to the triceps.

Discussion: The LTN may be a potential nerve donor for musculocutaneous or axillary nerve reinnervation in patients with brachial plexus injuries when other donors are not available during a primary plexus reconstruction. However, the best use may be for delayed neurotization of a free functioning muscle transfer after the initial plexus reconstruction has failed and no other donors are available.

Level of evidence: Level IV-therapeutic study.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Narakas AO, Hentz VR. Neurotization in brachial plexus injuries. Indication and results. Clin Orthop Relat Res. 1988;237:43–56.
    1. Bertelli JA, Ghizoni MF. Long thoracic nerve: anatomy and functional assessment. J Bone Joint Surg Am. 2005;87:993–998.
    1. Hovelaque A. Anatomie des nerfs craniens et rachidiens et du systeme grand sympatique chezl’homme. Paris, France: Gaston Doin et Cie; 1927.
    1. Martin RM, Fish DE. Scapular winging: anatomical review, diagnosis, and treatments. Curr Rev Musculoskelet Med. 2008;1:1–11.
    1. Gregg JR, Labosky D, Harty M, et al. Serratus anterior paralysis in the young athlete. J Bone Joint Surg Am. 1979;61:825–832.

MeSH terms