Jose J Monsivais1. 1. The Hand and Microsurgery Center of El Paso, 10175 Gateway West Suite 230, El Paso, Texas, 79925, United States; Clinical Professor, Burrell Osteopathic College of Medicine, Las Cruces, New Mexico, United States. Electronic address: handmicro@msn.com.
Abstract
OBJECTIVES: Peripheral neuropathic pain is a common and disabling problem after traumatic brachial plexus injury with global plexopathy secondary to C5 rupture and avulsion of C6, C7, C8, and T1. The purpose of this paper is to evaluate restoration of sensation and pain levels before and after targeted muscle reinnervation to the hand using contralateral C7 nerve transfers in patients who have traumatic brachial plexus injuries with C5 rupture and avulsion of C6, C7, C8, and T1. PATIENTS AND METHODS: This paper presents a retrospective review of the outcomes of the surgical management of 11 patients with global plexopathy with C5 rupture and avulsion from C6 to T1 roots. Ten of the patients had peripheral neuropathic pain. Mean follow-up was 6.9 years. RESULTS: Sensory recovery to the median nerve territory was returned in 10 out of 11 patients. Pain and quality of life were improved in the majority. CONCLUSION: Contralateral C7 nerve transfers may restore sensation to the median nerve territory with concurrent improvement in pain and some function in a limited number of patients for whom no other treatment options exist.
OBJECTIVES: Peripheral neuropathic pain is a common and disabling problem after traumatic brachial plexus injury with global plexopathy secondary to C5 rupture and avulsion of C6, C7, C8, and T1. The purpose of this paper is to evaluate restoration of sensation and pain levels before and after targeted muscle reinnervation to the hand using contralateral C7 nerve transfers in patients who have traumatic brachial plexus injuries with C5 rupture and avulsion of C6, C7, C8, and T1. PATIENTS AND METHODS: This paper presents a retrospective review of the outcomes of the surgical management of 11 patients with global plexopathy with C5 rupture and avulsion from C6 to T1 roots. Ten of the patients had peripheral neuropathic pain. Mean follow-up was 6.9 years. RESULTS: Sensory recovery to the median nerve territory was returned in 10 out of 11 patients. Pain and quality of life were improved in the majority. CONCLUSION: Contralateral C7 nerve transfers may restore sensation to the median nerve territory with concurrent improvement in pain and some function in a limited number of patients for whom no other treatment options exist.