CROSS-CHEST C7 NERVE GRAFTING FOLLOWED BY FREE MUSCLE TRANSPLANTATIONS FOR THE TREATMENT OF TOTAL AVULSED BRACHIAL-PLEXUS INJURIES - A PRELIMINARY-REPORT

The number of donor nerves available for nerve transfer in the reconst ruction of total root avulsion injuries of the brachial plexus is alwa ys insufficient. Use of the contralateral normal C7 cervical nerve as a donor nerve is a new approach to obtain more nerve fibers but also i s a controversial procedure. Fifteen patients with total root avulsion of the brachial plexus received cross-chest C7 nerve grafting as the first stage of reconstruction. Eight of these patients, after an inter val of 11 to 20 months, had free muscle transplantations (one to three muscles transferred per individual) to the affected limb. A long peri od of rehabilitation (at least 2 years) is required. The donor limbs o f the 15 patients showed negligible deficits of motor and sensory func tion. Although independent movement of the transferred muscles from th e contralateral limb has not been achieved, useful function of the rec onstructed limb is possible. The preliminary results are encouraging.