Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
The long thoracic nerve as a donor for elbow extension reconstruction in traumatic adult brachial plexus injuries.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Maciburko Simon, Ferris Scott
Аннотация
BACKGROUND AND AIMS: Elbow extension reconstruction in traumatic adult complete or extended partial brachial plexus injuries (BPIs) is challenging owing to the limited availability of reliable uninjured donor nerves. The intraplexal long thoracic nerve (LTn), offers an underused donor option is selected circumstances. Its segmental innervation of serratus anterior allows selective distal harvesting with minimal functional loss. However, its use has been described only in small, heterogeneous series with limited outcome data. We aimed to evaluate the clinical utility and outcomes of LTn transfers for elbow extension by comparing its application in native triceps versus free functioning muscle transfer (FFMT) reconstructions.
METHODS: This retrospective single surgeon cohort study included 10 consecutive adult patients with traumatic BPIs and M0 elbow extension who underwent LTn transfers to either native triceps or FFMTs using the gracilis muscle. Motor recovery was assessed using the MRC scale, with ≥M4 defined as a successful outcome. The follow-up was ≥38 months.
RESULTS: LTn transfers to the native triceps in early referred patients resulted in M4 recovery in 5 out of 6 patients. In late referred patients, 2 of 4 FFMT patients achieved M4 and the remaining 2 achieved M3. No major donor site morbidity occurred.
CONCLUSION: The LTn can be a powerful, retrainable donor for elbow extension in certain BPIs, particularly when it is used early for direct triceps reinnervation. Even in delayed presentations requiring FFMT, LTn transfer provides meaningful functional restoration, thereby supporting its inclusion in the reconstructive algorithm.
METHODS: This retrospective single surgeon cohort study included 10 consecutive adult patients with traumatic BPIs and M0 elbow extension who underwent LTn transfers to either native triceps or FFMTs using the gracilis muscle. Motor recovery was assessed using the MRC scale, with ≥M4 defined as a successful outcome. The follow-up was ≥38 months.
RESULTS: LTn transfers to the native triceps in early referred patients resulted in M4 recovery in 5 out of 6 patients. In late referred patients, 2 of 4 FFMT patients achieved M4 and the remaining 2 achieved M3. No major donor site morbidity occurred.
CONCLUSION: The LTn can be a powerful, retrainable donor for elbow extension in certain BPIs, particularly when it is used early for direct triceps reinnervation. Even in delayed presentations requiring FFMT, LTn transfer provides meaningful functional restoration, thereby supporting its inclusion in the reconstructive algorithm.