%0 Journal Article
%T Contralateral C7 nerve transfer - Our experiences over past 25 years
%A Cheng-Gang Zhang
%A Yu-Dong Gu
%J Journal of Brachial Plexus and Peripheral Nerve Injury
%D 2011
%I Thieme Medical Publishers
%R 10.1186/1749-7221-6-10
%X It has been 25 years since the world's first case of contralateral C7 nerve transfer finished in our clinic in August 1986 [1]. We now summarize our experiences regarding this technique.Brachial plexus avulsion injury represents one of the most devastating injuries of the upper extremity. Nerve transfer is the most frequently used method in restoring limb function. So far, various techniques have been used, intraplexus or extraplexus, including accessory nerve transfer, intercostal nerve transfer, phrenic nerve transfer etc. However, with the fast development of high-velocity traffic, there have been increasing high-energy accidents over the recent years which resulted in more extensive trauma. In these cases, even fewer donor nerves could be used in neurotization. This prompts us to seek more donor sources for brachial plexus reconstruction.In June 1986, a 28-year old man sustained hemopneumothorax due to 3rd-6th costal fractures and brachial plexus injury in the left side during a motor cycle accident. He was referred to our clinic 2 months after initial trauma due to there has been no spontaneous recovery of the upper limb function. Upon physical examination, a positive Claude Bernard-Horner's sign was found. The function of the shoulder, elbow, wrist and hand was completely lost. Plain chest X-ray film also showed elevation of the left diaphragm. Electromyogram detected no SEP from C5-T1 nerve roots and NAP could be recorded. The diagnosis was preganglionic injury of the C5-T1 nerve roots, ie., total root avulsion injury of the brachial plexus. The EMG exam also suggested concomitant complete palsy of the accessory nerve and phrenic nerve. Based on our observation of over 1000 cases of brachial plexus injuries, no patient suffered functional loss from single C7 root injury, therefore we postulated that C7from the healthy limb may be sacrificed and used as a donor nerve to reconstruct the injured plexus. During surgical exploration of the affected plexus, C5-T1 n
%U http://www.jbppni.com/content/6/1/10