Restoration of elbow flexion with Intercostal nerve transfer

April 24th, 2007

When brachial plexus injury has occurred, and nerves have been avulsed from the cervical spinal cord, reconstructive strategies center around nerve transfer surgery. These techniques are typically used in an attempt to restore shoulder and elbow flexion.

Intercostal nerve transfers can be used to restore elbow flexion. This surgery is complex--involving transfer of the 3rd, 4th, and 5th Intercostal nerves from the normal location inferior to each of the respectively numbered ribs--to the motor nerve to the elbow's biceps muscle. The goal is elbow flexion that is strong enough to overcome gravity and perform light lifting.

Successful outcome frees the patient from having to be in a sling for support.When I evaluate your brachial plexus injury in the office, I may need to order additional studies, which, in combination with your physical exam, will allow me to share the potential treatment options with you.

Related Photos:

The 3rd, 4th and 5th Intercostal nerves can be used for transfer

Preoperative skin markings. The pectoralis major can be retracted upward for exposure of the ribs

Vessel loops are around the 4th and 5th IC nerves

Nerve transfer has bee completed