This study investigated the anatomical feasibility of contralateral pectoral-nerve transfer as a donor strategy for innervation in cases of total brachial plexus root avulsion, aiming to provide a foundation for future clinical application. Six human thoracic specimens (twelve hemithoraces) were dissected through an infraclavicular approach to expose the lateral and medial pectoral nerves and the ansa pectoralis, while preserving the musculocutaneous and axillary nerves as landmarks. Nerve origins, course, branching patterns, lengths, and thickness were recorded, and distances to the contralateral axillary and musculocutaneous nerves were measured. In all specimens, the pectoral nerves are divided into superior, middle, and inferior branches connected by an ansa pectoralis. The superior and middle branches originated from the lateral cord, and the inferior branch from the medial cord, piercing the pectoralis minor in half of the cases. Mean distances from the contralateral axillary nerve to the superior, middle, and inferior branches were 265 ± 24 mm, 283 ± 20 mm and 305 ± 21 mm, respectively, and to the musculocutaneous nerve 290 ± 26 mm, 302 ± 27 mm and 316 ± 28 mm. Mean thickness were 11.2 ± 1.0 mm (superior), 13 ± 1.9 mm (middle) and 14.5 ± 1.4 mm (inferior), compared to 25.3 ± 2.4 mm for the axillary nerve. Morphometric findings demonstrate that contralateral pectoral nerve transfer is anatomically feasible for axillary and musculocutaneous reinnervation. The superior branch provides the most favorable donor geometry, minimizing the bridging distance to contralateral targets, whereas deeper branches may suit distal reinnervation.
Almeida et al. (Thu,) studied this question.