Triceps nerve to deltoid nerve transfer after an unsatisfactory intra-plexus neurotization of the posterior division of the upper trunk

Abstract

Introduction Our literature review did not reveal any study on the results of triceps to deltoid nerve transfer done as a secondary procedure after an unsatisfactory primary intraplexus neurotization of the posterior division of the upper trunk. Presentation of cases We report on three adults with C5-C6 brachial plexus injury who had an unsatisfactory deltoid function following primary intraplexus neurotization. Patients presented to our clinic late (14–16 months after injury). All patients had poor shoulder abduction (<40°) despite the presence of visible and palpable deltoid contractions. A triceps to deltoid nerve transfer resulted in an excellent shoulder abduction (> 150°) in all patients. Discussion The primary surgery in our patients acted as a “baby-sitter” procedure; explaining the good results of the late secondary distal nerve transfer. Conclusion Good results may be obtained from a late distal nerve transfer for the deltoid muscle as long as there is partial innervation of the muscle.