Case Report: Double Oberlin Nerve Transfer to Restore Elbow Flexion Following C5‐C6 Avulsion Injury. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Moses, Michael J; Dai, Amoz Z; Lowe, Dylan T; Chu, Alice; Protopsaltis, Themistocles S
• Is Part Of: Operative neurosurgery. Volume 16:Issue 1(2019)
• Publication Date: 2019-01
• Subjects: Avulsion injury -- Biceps brachii -- Brachial plexus -- Cervical spine -- Elbow flexion -- Nerve -- Nerve transfer; Nervous system -- Surgery -- Periodicals; 617.480590
• DOI: 10.1093/ons/opy064
• Languages: English
• ISSNs: 2332-4252

Abstract

Abstract : BACKGROUND AND IMPORTANCE: : The use of nerve transfers to restore nerve function following traumatic avulsion injuries has been described, though there is still a paucity in the literature documenting technique and long‐term outcomes for these procedures. The double Oberlin nerve transfer involves transferring fascicles from the median and ulnar nerves to the musculocutaneous nerve to restore elbow flexion in patients with a C5‐C6 avulsion injury. The purpose of this case report is to present our indications and technique for a double Oberlin transfer in addition to exhibiting video footage at follow‐up time points documenting the incremental improvement in elbow flexion following the injury. CLINICAL PRESENTATION: : The patient is a 25‐yr old, left‐hand dominant male who presented 5 mo following a motor vehicle accident. He had 0/5 biceps muscle strength on the left with a computed tomography myelogram that demonstrated pseudomeningoceles from C2‐C3 to C7‐T1 with root avulsions of C5 and C6. He was subsequently indicated for a double Oberlin nerve transfer to restore elbow flexion. CONCLUSION: : In this case report, we present our technique and outcomes for a double Oberlin transfer with restoration of elbow flexion at 1‐yr follow‐up for a patient with traumatic brachial plexus injury. We believe that the double Oberlin transfer serves as a safe and effective method to restore elbow flexion in this patient population.