Radial Medial Head Triceps Branch Transfer to Axillary Nerve by Axillary Approach

Abstract

Objective To describe axillary approach for axillary nerve transfer with radial nerve branch in brachial plexus lesions.

Methods Six patients aged 24 to 54 (mean 30) years with traumatic superior trunk brachial plexus injury underwent axillary approach between October 2011 and April 2012. On physical examination prior to surgery, they could not perform shoulder abduction, external rotation, or elbow flexion. Surgical approach was made through axillary pathway without any muscular section. The transfer was done with the radial branch to the medial head of triceps. In addition to transfer to axillary nerve, each patient had spinal accessory nerve transferred to suprascapular nerve and ulnar nerve fascicle transferred to musculocutaneous nerve.

Conclusion The axillary approach allows easy access to axillary nerve and, therefore, is a feasible pathway to transferences involving this nerve.

Resumo

Objetivo Apresentar via axilar por transferência de nervo axilar com ramo de nervo radial em lesões do plexus braquial.

Métodos Seis pacientes com idade entre 24 e 54 anos (média de 30) com lesão braquial traumática do plexus no tronco superior submetidos a via axilar entre outubro de 2011 e abril de 2012. Em exame físico pré-cirúrgico, não foram capazes de executar abdução do ombro, rotação externa, ou flexão do cotovelo. Abordagem cirúrgica foi realizada por passagem axilar sem qualquer seção muscular. A transferência ocorreu com o ramo radial do tríceps medial da cabeça. Somada à transferência ao nervo axilar, cada paciente teve nervo acessório espinhal transferido para o nervo supraescapular, e o fascículo do nervo ulnar transferido para o nervo musculocutâneo.

Conclusão A via axilar facilita acesso ao nervo axilar e, por isso, é um caminho factível para transferências envolvendo este nervo.

Keywords

axillary nerve - brachial plexus - transfer

Palavras chave

nervo axilar - plexus braquial - transferência

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