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Outcome of partial contralateral C7 nerve transfer--results of 46 patients.

BACKGROUND
: Partial contralateral C7 transfer has been widely used, but outcomes are significantly different. Therefore, the effects of this procedure need to be evaluated.


OBJECTIVE
: To evaluate the outcome of patients treated with partial contralateral C7 transfer and to determine the factors affecting the outcome of this procedure. METHODS;: A retrospective review of 46 patients with global root avulsion brachial plexus injuries who underwent contralateral C7 transfer was conducted. All surgeries were performed by two stages and median nerve was the recipient nerve. The contralateral C7 nerve was used in three different ways. The whole C7 root was used in 8 patients; the posterior division together with the lateral part of the anterior division was used in 14 patients; and the anterior or the posterior division alone was used in 24 patients. The mean follow-up period was 6.4 years.


RESULTS
: The effective rate of these 46 patients was 47.83% in motor and 56.52% in sensory function. The patients with whole C7 root transfer obtained significantly better recovery than the patients with partial C7 transfer. The best functional recovery was seen if the interval between the two stages was 4 to 8 months.


CONCLUSION
: Partial contralateral C7 transfer is an effective procedure in treating global brachial plexus avulsion injury. Using the whole C7 root transfer can obtain better recovery and we emphasize using the whole root as the donor. The optimal interval between the two surgery stages is 4 to 8 months.