Triceps nerve to deltoid nerve transfer after an unsatisfactory intra-plexus neurotization of the posterior division of the upper trunk

Highlights • We present 3 cases of late distal nerve transfer to deltoid. • The outcome was excellent despite the delay from time of injury. • This was explained by the presence of partial muscle innervation.
Introduction Our literature review did not reveal any study on the results of triceps to deltoid nerve transfer done as a secondary procedure after an unsatisfactory primary intraplexus neurotization of the posterior division of the upper trunk. Presentation of cases We report on three adults with C5-C6 brachial plexus injury who had an unsatisfactory deltoid function following primary intraplexus neurotization. Patients presented to our clinic late (14–16 months after injury). All patients had poor shoulder abduction ( 150°) in all patients. Discussion The primary surgery in our patients acted as a “baby-sitter” procedure; explaining the good results of the late secondary distal nerve transfer. Conclusion Good results may be obtained from a late distal nerve transfer for the deltoid muscle as long as there is partial innervation of the muscle.