Article

Nerve transfer of the nerve branch to long head of triceps onto the axillary
nerve has joined the therapeutic armamentarium for isolated deltoid paralysis
cases. We report our experience in the case of a non-excisable neuroma of the
axillary nerve at its origin from the posterior cord.
METHODS: Eight patients of
average age 28 (15-38) were included in a retrospective study with one operating
surgeon. Clinical assessment included analytical testing of the deltoid muscle,
pain score (VAS) and a functional assessment. Minimum follow-up was 24 months.
RESULTS: Preoperative delay was 10.8 months. In seven cases, recovery was M4 for
the posterior deltoid, M3 for the middle deltoid and M2 for the anterior deltoid.
The elbow was stable, strong and painless (VAS=2). Cocontraction was found. No
morbidity was found at the donor site. The last case was a failure. DISCUSSION:
In absence of spontaneous recovery, the surgical treatment of deltoid palsy
restores a stable strong shoulder and prevents overloading of the rotator cuff.
This nerve transfer initially used in brachial plexus surgery gives results
comparable to those using grafts, which is the standard treatment of reference
avoiding approach of the plexus. The inconvenience is the persistence of
cocontractions and a fatigue phenomenon. CONCLUSION:
The nerve transfer of the
nerve to the long head of triceps to the axillary nerve is the technique of
choice for re-innervation of the deltoid.
CI - Copyright (c) 2012. Published by Elsevier SAS.

Langue : FRANCAIS