Surgical Treatment by Nerve Transfers for Combined Injuries of the Axillary and Suprascapular Nerves

DOI
  • ASADA Yoshiyuki
    <i>Department of Orthopaedic Surgery, Kitano Hospital, The Tazuke Kofukai</i>
  • KAKINOKI Ryosuke
    <i>Department of Rehabilitation, Kyoto University Hospital</i>
  • IKEGUCHI Ryosuke
    <i>Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital</i>

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Other Title
  • 肩甲上・腋窩神経合併損傷に対する神経移行術の経験

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Description

 Two cases of combined injuries of the axially and suprascapular nerves were treated surgically by nerve transfers.<br> Case 1: A 32-year-old male was injured in a motorcycle accident. The time from trauma to operation was 6 months. The surgical procedure for the suprascapular nerve was neurolysis, and that for the axillary nerve was transfer of two of the triceps lateral head motor branches. Shoulder abduction recovery was 90° and anterior flexion recovery was 100° at 20 months after the operation.<br> Case 2: A 27-year-old male was injured in a motorcycle accident and underwent osteosynthesis of a humeral shaft fracture. The time from trauma to surgery was 7 months. The surgical procedure for the suprascapular nerve was transfer of the terminal branch of the accessory nerve with a sural nerve graft. The surgical procedure for the axillary nerve was transfer of two of the triceps lateral head motor branches. Shoulder abduction recovery was 140° and anterior flexion recovery was 90° at 26 months after the operation.<br> These procedures consisted of motor nerve transfers to recipient motor nerves, and allowed the connection of the healthy donor and recipient nerves. In addition, nerve transfers can be performed close to the target muscles. The proposed nerve transfer procedures are therefore considered to be a valid strategy for treating combined injuries of the axillary and suprascapular nerves.

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