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In patients with C5–C6 brachial plexus injury, restoration of shoulder abduction is usually achieved by the spinal accessory nerve (SAN) transfer to the suprascapular nerve. In order to minimize donor deficits, we transfer one fascicule of the ipsilateral C7 root, dedicated to the pectoralis major (PM) muscle, to the suprascapular nerve (SSN) (Cambon-Binder and Belkheyar, Plast Reconstr Surg 149(3):672–675, 2022). In a nine-patient series, we showed that this technique gave reliable results in terms of range of motion and strength. At a mean follow-up of 36 months, patients recovered mean shoulder abduction and external rotation of 99° and 58°, respectively. Shoulder abduction and external rotation strength were graded M4, according the BMRC grading scale, in all patients but one. Residual strength of the pectoralis major was superior to M4 in every patient. In our practice, this technique replaced the spinal accessory nerve transfer.

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Transfer of a C7 Fascicule for the Pectoralis Major to the Suprascapular Nerve

  • 章节

  • 发表日期：

    2025年

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  • Belkheyar Zoubir,
  • Cambon Adeline,
  • Oberlin Christophe

摘要

In patients with C5–C6 brachial plexus injury, restoration of shoulder abduction is usually achieved by the spinal accessory nerve (SAN) transfer to the suprascapular nerve. In order to minimize donor deficits, we transfer one fascicule of the ipsilateral C7 root, dedicated to the pectoralis major (PM) muscle, to the suprascapular nerve (SSN) (Cambon-Binder and Belkheyar, Plast Reconstr Surg 149(3):672–675, 2022). In a nine-patient series, we showed that this technique gave reliable results in terms of range of motion and strength. At a mean follow-up of 36 months, patients recovered mean shoulder abduction and external rotation of 99° and 58°, respectively. Shoulder abduction and external rotation strength were graded M4, according the BMRC grading scale, in all patients but one. Residual strength of the pectoralis major was superior to M4 in every patient. In our practice, this technique replaced the spinal accessory nerve transfer.