Nerve grafting versus nerve transfers for restoration of shoulder and elbow function after traumatic brachial plexus palsy

Background:Treating brachial plexus injuries is challenging. Accurate localization of the injury through physical examination, imaging, and electrodiagnostic studies is essential for effective treatment. The timing of repair is a key factor in determining the outcome. Early intervention within the first three months is widely agreed upon as beneficial, especially when recovery is unlikely without it. Patients and methods:This retrospective and prospective clinical comparative non randomized study was helded in Plastic Surgery departments at Minia University Hospitals and at Zagazig University Hospitals on 40 patients (20 prospective and 20 retrospective). Patients were allocated into two groups according to type of procedure: Group A: Patients previously were operated up on with nerve grafting. Group B: Patients were operated up on with nerve transfers Results: Regarding the comparison of Post operative outcome According to MRC between studied groups, the results were statistically significant (p value =0.007, 0.005 and 0.01 for Shoulder abduction, Shoulder flexion and Elbow flexion respectively) as shown in table 4 For shoulder abduction more than one half of cases had MRC 4 (55%) compared to 20% among cases of group I, while percentage of cases with MRC I and II were significantly higher in group I (5% and 45% respectively) than among cases of group II (0% and 5% respectively). Conclusion:Our study stated that nerve transfer procedures more efficient than the traditional nerve grafting used in primary restoration of shoulder and elbow function after traumatic brachial plexus palsy.