American Society for Peripheral Nerve

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Intercostal nerve transfer to suprascapular nerve after brachial plexus roots avulsion
Shaonan Hu, PhD
Department of Hand Surgery, Huashan Hospital, Fu Dan University, Shanghai, China

Objective: The purpose of this investigation was to perform anatomic study on the intercostal nerve transfer to the suprascapular nerve and a case report

Methods: 30 thoracic walls of human cadavers were used to investigate the anatomical possibility for the repairment of the suprascapular nerve by using Intercostal Nerves III-‡Y. The dissections of the intercostal nerves from the thoracic walls were done to measure the length of the intercostal nerves from the midclavicular line to the midaxillary line(L) and the distance from the relevant intercostal space to the middle of the clavicle(D).

Results: The results showed that the differences between L and D of III-‡Yintercostal nerves were calculate as(2.50±1.06)cm?A(1.63±1.36)cm?A(-0.20±1.45)cm?A(-3.51±2.16)cm respectively.

Conclusions: So we believed that the intercostal nerve III and ‡W could be transferred to the suprascapular nerve without nerve graft. Since the Suprascapular nerve could be dissociated and stretched about 2 centimeters under the clavicle, the intercostal nerve V could also be transferred to the suprascapular nerve directly. The intercostal nerve ‡Y could be neurotized to the suprascapular nerve with nerve graft or increasing the dissection length of the intercostal nerve. Based on this study, An 42 yrs male who had a motorcycle crash one month before, he had C5-7 roots avulsion and partial injury of C8, T1 of the right side, the accessory nerve was also injured. We transferred intercoastal nerve III and IV to superscapular nerve and intercostals nerve V-VIII to musculocutaneous nerve, after 32 months postoperative, the patients got 30 degrees of shoulder abduction and 45 degrees of external rotation, also, he had 90 degrees of elbow flexion.

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