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

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 t...

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Autores principales: Wells, Matthew E., Gonzalez, Gilberto A., Childs, Benjamin R., Williams, Matthew R., Nesti, Leon J., Dunn, John C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544396/
https://www.ncbi.nlm.nih.gov/pubmed/33133948
http://dx.doi.org/10.1097/GOX.0000000000003096
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author Wells, Matthew E.
Gonzalez, Gilberto A.
Childs, Benjamin R.
Williams, Matthew R.
Nesti, Leon J.
Dunn, John C.
author_facet Wells, Matthew E.
Gonzalez, Gilberto A.
Childs, Benjamin R.
Williams, Matthew R.
Nesti, Leon J.
Dunn, John C.
author_sort Wells, Matthew E.
collection PubMed
description 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.
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spelling pubmed-75443962020-10-29 Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review Wells, Matthew E. Gonzalez, Gilberto A. Childs, Benjamin R. Williams, Matthew R. Nesti, Leon J. Dunn, John C. Plast Reconstr Surg Glob Open Hand/Peripheral Nerve 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. Lippincott Williams & Wilkins 2020-09-23 /pmc/articles/PMC7544396/ /pubmed/33133948 http://dx.doi.org/10.1097/GOX.0000000000003096 Text en Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
spellingShingle Hand/Peripheral Nerve
Wells, Matthew E.
Gonzalez, Gilberto A.
Childs, Benjamin R.
Williams, Matthew R.
Nesti, Leon J.
Dunn, John C.
Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
title Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
title_full Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
title_fullStr Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
title_full_unstemmed Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
title_short Radial to Axillary Nerve Transfer Outcomes in Shoulder Abduction: A Systematic Review
title_sort radial to axillary nerve transfer outcomes in shoulder abduction: a systematic review
topic Hand/Peripheral Nerve
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544396/
https://www.ncbi.nlm.nih.gov/pubmed/33133948
http://dx.doi.org/10.1097/GOX.0000000000003096
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