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3459 Brachial plexus injury and restoration of elbow flexion, a cadaveric study

bmjno · 2025-10-23 · canonical JSON source

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Background/Objectives The brachial plexus innervates the majority of the upper limb, making injuries to it catastrophic for the young men they commonly affect. Brachial plexus injuries are usually supraclavicular, affecting the upper roots of the plexus resulting in loss of elbow flexion and shoulder abduction.Surgeries to repair brachial plexus injuries consist of nerve transfers, grafts, or tendon transfers. Of these procedures, nerve transfer offers the fastest reinnervation time, whilst allowing the surgeon to avoid the field of the original injury.We aimed to demonstrate the underlying anatomy of the brachial plexus with a focus on elbow flexion, the priority function to restore when lost, highlighting its anatomical course and proximity of viable nerves to transfer.Method This research project was a cadaveric dissection of the upper limb, demonstrating the brachial plexus anatomy in detail from its origin to its innervation of the biceps brachii as well as surrounding structures.Results There are multiple viable nerves available for transfer to the biceps brachii or musculocutaneous nerve. The images of the cadaveric dissection demonstrate the anatomical relation between the ulnar, median, thoracodorsal and medial pectoral nerve which are the primary nerve transfers used to restore elbow flexion.Conclusion There are multiple motor nerves in close proximity to and of a similar size to the musculocutaneous nerve that could be used for nerve transfer to restore elbow flexion in the management of brachial plexus injuries.