Medial Pectoral Nerve to Axillary Nerve Neurotization following Traumatic Brachial Plexus Injuries: Indications and Clinical Outcomes

INTRODUCTION: The medial pectoral nerve (MPN) represents a viable donor nerve for neurotization procedures for restoration of shoulder function following upper trunk brachial plexus injuries. MATERIALS AND METHODS: We report an eight-case series, single-surgeon experience of patients with upper trunk brachial plexus injuries who underwent MPN to axillary nerve (AXN) transfer from 2001-2007 for shoulder stability and abduction. RESULTS: The mean patient age was 31.5 (range, 19-51 years). The mean follow-up for all patients was 22.25 ± 7.4 months. Surgery was performed at a mean of 5.8 ± 2.9 months post-injury. On initial evaluation, all eight patients had no deltoid function (M0). Of the eight patients examined postoperatively, we observed excellent recovery in four, good recovery in two, fair recovery in one, and poor functional recovery in the remaining patient. DISCUSSION: MPN to AXN neurotization is a valid surgical option in the restoration of shoulder stability and shoulder abduction following trauma-related upper trunk brachial plexus injury.