Abstrakt
While a number of theoretical and experimental studies dealing with end-to-side neurorrhaphy have been published to date, there is still a considerable lack of clinical trials. Here, we describe our experience with end-to-side neurorrhaphy in axillary and musculocutaneous nerve reconstruction in patients with brachial plexus palsy.
Methods: Out of 791 reconstructed nerves in 441 patients with brachial plexus injury treated from 1993 to 2011, we performed 21 axillary and two musculocutaneous nerves sutures onto the median, ulnar and radial nerves from 1999 to 2007. This technique was only performed in patients whose donor nerves, such as thoracodorsal and medial pectoral nerve, which we generally use for repair of axillary and musculocutaneous nerves respectively, were not available.
In all patients, a perineurial suture was carried out after the creation of a perineurial window. The overall success rate of end-to-side neurorrhaphy was 43.5%.
While reinnervation of the deltoid muscle was successful in 47.6% of patients, reinnervation of the biceps muscle was unsuccessful in both cases. We conclude that end-to-side neurorrhaphy should be performed in axillary nerve reconstruction, but only when commonly used donor nerves are not available.