Neuro-neural intraplexal transfers in traumatic radicular avulsions of the brachial plexus. Report on fifteen cases.

Neurotization with regional undamaged nerves is the principal method available for treating avulsive lesions of the brachial plexus, but the number of donor axons is low. If a patient presents traumatic brachial plexus roots avulsions associated with extraforaminal ruptures of brachial plexus roots the authors propose to use the latter stumps to reinnervate the brachial plexus below the site of the lesion (neuro-neural intra-plexal transfers). 15 patients with 28 neuro-neural intra-plexal transfers are studied; the average follow-up is 5 years and 6 months. The synkinesias are frequent (8 patients) and can cancel a positive motor result. Nevertheless, 15 of the 28 transfers gave a useful motor result at long term follow-up. The neuro-neural intra-plexal transfers are an alternative method in treating traumatic brachial plexus lesions with spinal root avulsions when plexus root stumps are available.