ANATOMIC STUDY ON INTERCOSTAL NERVE TRANSFER TO SUPRASCAPULAR NERVE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHU Bin , HU Shaonan , CHEN Liang , SONG Jie.

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, P.R.China. Corresponding author: HU Shaonan, E-mail: shaonan_hu@yahoo.com;

Corresponding author：

Keywords：

Intercostal nerve transfer; Suprascapular nerve; Nerve repair; Anatomic study

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ObjectiveTo investigate the feasibility of the 3rd-6th intercostal nerve transfer to the suprascapular nerve for reconstruction of shoulder abduction. MethodsFifteen thoracic walls (30 sides) were collected from human cadavers. The 3rd-6th intercostal nerve length which can be dissected between the midaxillary line and midclavicular line, and the transfer distance between the midaxillary line and midpoint of the clavicular bone (prepared point for neurotization) were measured. ResultsIn 30 sides of specimens, the 3rd and 4th intercostal nerves could be obtained between the midaxillary line and midclavicular line, the available length of which was significantly greater than the transfer distance (P lt; 0.01). Six sides of the 5th intercostal nerve and 16 sides of 6th intercostal nerve were covered by the costal cartilage before reaching the midclavicular line. The available length of the 5th intercostal nerve was similar to the transfer distance (P gt; 0.01), while the available length of the 6th intercostal nerve was significantly less than transfer distance (P lt; 0.01). The suprascapular nerve could be dissociated and turned to the clavicular bone of more than 2 cm. The whole length of the available 5th intercostal nerve length and the turning length (2 cm) of suprascapular nerve was significantly greater than the transfer distance (P lt; 0.01), but for the 6th intercostal nerve, the whole length was still less than transfer distance (P lt; 0.01). ConclusionIt could be an alternative method to use the 3rd, 4th, and 5th intercostal nerve transfer to the suprascapular nerve for reconstruction of shoulder abduction. And for the 6th intercostal nerve, longer dissociated length may be required for direct coaptation or using a graft for nerve repair.

Citation： CHU Bin,HU Shaonan,CHEN Liang,SONG Jie.. ANATOMIC STUDY ON INTERCOSTAL NERVE TRANSFER TO SUPRASCAPULAR NERVE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1095-1097. doi: Copy

1.	Terzis JK, Kostopoulos V. The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg, 2007, 119(4): 73e-92e.
2.	官士兵, 陈德松, 方有生, 等. 副神经移位修复臂丛损伤受区神经选择的探讨. 中国矫形外科杂志, 2004, 12(3): 182-184.
3.	Asfazadourian H, Tramond B, Dauge MC, et al. Morphometric study of the upper intercostal nerves: practical application for neurotizations in traumatic brachial plexus palsies. Chir Main, 1999, 18(4): 243-253.
4.	Malungpaishrope K, Leechavengvongs S, Uerpairojkit C, et al. Nerve transfer to deltoid muscle using the intercostal nerves through the posterior approach: an anatomic study and two case reports. J Hand Surg (Am), 2007, 32(2): 218-224.
5.	Samardzić M, Rasulić L, Grujicić D, et al. Results of nerve transfers to the musculocutaneous and axillary nerves. Neurosurgery, 2000, 46(1): 93-103.
6.	Oberlin C. Brachial plexus palsy in adults with radicular lesions, general concepts, diagnostic approach and results. Chir Main, 2003, 22(6): 273-284.
7.	Durand S, Oberlin C, Fox M, et al. Transfer of the first intercostal nerve to supra- and infraspinatus muscles: an anatomical study and report of the first case. J Hand Surg Eur Vol, 2009, 34(2): 196-200.
8.	Rockwood CA Jr, Matsen FA III. The Shoulder. Philadelphia: WB Saunders, 1998: 233-276.
9.	官士兵, 陈德松, 方有生, 等. 后进路副神经移位修复肩胛上神经术式的解剖学研究. 中华手外科杂志, 2004, 20(1): 55-57.
10.	王树峰, 张高孟, 顾玉东, 等. 锁骨下水平副神经切断移位修复肩胛上神经的临床观察. 中华骨科杂志, 2000, 20(10): 594-597.
11.	Chuang DC. Neurotization procedures for brachial plexus injuries. Hand Clin, 1995, 11(4): 633-645.
12.	Narakas AO. Thoughts on neurotization or nerve transfers in irreparable nerve lesions. Clin Plast Surg, 1984, 11(1): 153-159.
13.	Omer GE Jr, Spinner M, Van Beek LA. Management of peripheral nerve problems. 2nd Ed. Philadelphia: WB Saunders, 1998: 459-464.
14.	林浩东, 方有生, 陈德松. 胛上神经卡压综合征的后入路手术应用. 中国修复重建外科杂志, 2005, 19(11): 899-901.
15.	刘巍巍. 改良后入路副神经移位修复肩胛上神经术式解剖学及临床研究. 长春: 吉林大学, 2008.
16.	Asfazadourian H, Tramond B, Dauge MC, et al. Morphometric study of the upper intercostal nerves: practical application for neurotisations in traumatic brachial plexus palsies. Chir Main, 1999, 18(4): 243-253.
17.	El-Gammal TA, Fathi NA. Outcomes of surgical treatment of brachial plexus injuries using nerve grafting and nerve transfers. J Reconstr Microsurg, 2002, 18(1): 7-15.

1. Terzis JK, Kostopoulos V. The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg, 2007, 119(4): 73e-92e.
2. 官士兵, 陈德松, 方有生, 等. 副神经移位修复臂丛损伤受区神经选择的探讨. 中国矫形外科杂志, 2004, 12(3): 182-184.
3. Asfazadourian H, Tramond B, Dauge MC, et al. Morphometric study of the upper intercostal nerves: practical application for neurotizations in traumatic brachial plexus palsies. Chir Main, 1999, 18(4): 243-253.
4. Malungpaishrope K, Leechavengvongs S, Uerpairojkit C, et al. Nerve transfer to deltoid muscle using the intercostal nerves through the posterior approach: an anatomic study and two case reports. J Hand Surg (Am), 2007, 32(2): 218-224.
5. Samardzić M, Rasulić L, Grujicić D, et al. Results of nerve transfers to the musculocutaneous and axillary nerves. Neurosurgery, 2000, 46(1): 93-103.
6. Oberlin C. Brachial plexus palsy in adults with radicular lesions, general concepts, diagnostic approach and results. Chir Main, 2003, 22(6): 273-284.
7. Durand S, Oberlin C, Fox M, et al. Transfer of the first intercostal nerve to supra- and infraspinatus muscles: an anatomical study and report of the first case. J Hand Surg Eur Vol, 2009, 34(2): 196-200.
8. Rockwood CA Jr, Matsen FA III. The Shoulder. Philadelphia: WB Saunders, 1998: 233-276.
9. 官士兵, 陈德松, 方有生, 等. 后进路副神经移位修复肩胛上神经术式的解剖学研究. 中华手外科杂志, 2004, 20(1): 55-57.
10. 王树峰, 张高孟, 顾玉东, 等. 锁骨下水平副神经切断移位修复肩胛上神经的临床观察. 中华骨科杂志, 2000, 20(10): 594-597.
11. Chuang DC. Neurotization procedures for brachial plexus injuries. Hand Clin, 1995, 11(4): 633-645.
12. Narakas AO. Thoughts on neurotization or nerve transfers in irreparable nerve lesions. Clin Plast Surg, 1984, 11(1): 153-159.
13. Omer GE Jr, Spinner M, Van Beek LA. Management of peripheral nerve problems. 2nd Ed. Philadelphia: WB Saunders, 1998: 459-464.
14. 林浩东, 方有生, 陈德松. 胛上神经卡压综合征的后入路手术应用. 中国修复重建外科杂志, 2005, 19(11): 899-901.
15. 刘巍巍. 改良后入路副神经移位修复肩胛上神经术式解剖学及临床研究. 长春: 吉林大学, 2008.
16. Asfazadourian H, Tramond B, Dauge MC, et al. Morphometric study of the upper intercostal nerves: practical application for neurotisations in traumatic brachial plexus palsies. Chir Main, 1999, 18(4): 243-253.
17. El-Gammal TA, Fathi NA. Outcomes of surgical treatment of brachial plexus injuries using nerve grafting and nerve transfers. J Reconstr Microsurg, 2002, 18(1): 7-15.

Chinese Journal of Reparative and Reconstructive Surgery

ANATOMIC STUDY ON INTERCOSTAL NERVE TRANSFER TO SUPRASCAPULAR NERVE

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