Upper brachial plexus lesions in adults: long term results of direct infraspinatus muscle reinnervation with a radial nerve branch transfer.

Introduction Although shoulder external rotation is crucial for upper limb functionality, attempts to restore it are not well represented in traumatic brachial plexus palsy literature. Methods A series of seven patients underwent a modified technique for direct reinnervation of the infraspinatus muscle using a branch of the radial nerve. They were evaluated after long-term follow-up. Results All seven patients recovered some degree of shoulder external rotation, and in five cases (71.42%) the recovery was equal to or greater than 45°, which was considered a good result. The median follow-up was 4.7 years (range 3-6 years). Conclusions The transfer of a branch of the radial nerve supplying the triceps muscle to the branch of the suprascapular nerve supplying the infraspinatus muscle is effective and may increase the possibility of functional recovery of shoulder external rotation. This technique should be included in the surgical armamentarium for nerve surgeons.