Contralateral cervical 7 as a potential donor in nerve transfer of adult brachial plexus injury especially in root avulsion case: A case report
1 Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
2 Cell and Tissue Bank, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Case Study
World Journal of Advanced Research and Reviews, 2023, 19(03), 1099–1102
Publication history:
Received on 04 August 2023; revised on 14 September 2023; accepted on 16 September 2023
Abstract:
Introduction: Contralateral cervical 7 (CC7) nerve transfer can be used in the absence of neurotizer in the BPI total root avulsion case. CC7 nerve transfer was introduced by Gu et al. in 1986, and aimed to restore motor and sensory function in the hand. The purpose of this paper is to report BPI patients with nearly total root avulsion using CC7 nerve transfer to the median nerve.
Case Presentation: A man suffered a motorcycle accident in March 2010. There was a complete loss of motor and sensory in the right upper limb. From the examination, it was obtained that the cervical root avulsion of C5-6, C7 postganglionic rupture and cervical root avulsion of C8-T1. In April of 2010 has been done root neurotization C4 to C5, C3 root neurotization was to the suprascapular nerve, neurotization of the phrenic nerve to C6, neurotization C7 to C6 with graft, and neurotization CC7 to median nerve with vascularized pedicle ulnar graft. An evaluation was made at the donor and recipient sites. From the first admission he had total motoric loss to the last evaluation for 5 years post operation of motoric in the recipient site showed range of motion (ROM) of elbow flexion recovered to M4 with ROM 135o, shoulder abduction reached M3 30 o, finger flexion recovered to M2, and hand sensation came up to S1. There was no morbidity on the donor site from the first evaluation.
Conclusion: Therefore, CC7 can be a potential donor in nerve transfer of adult BPI root avulsion cases without causing morbidity in the donor site.
Keywords:
Brachial plexus injury; Total root avulsion; Contralateral C7 transfer; Median nerve
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