Surgical Procedures

Medial Triceps Branch to Axillary Nerve Transfer

The medial triceps branch to axillary nerve transfer is an available option for reconstructing patients with shoulder deficits that include an axillary nerve injury. Not presented in this tutorial, the accessory to suprascapular nerve transfer is additionally performed to stabilize the humerus during its range-of-motion in these patients. The triceps to axillary nerve transfer specifically innervates the deltoid and teres minor. The superior lateral cutaneous branch of the axillary nerve is provided with rudimentary sensation through an end-to-side nerve transfer to the sensory component of the radial nerve. The surgical approach involves proceeding between the long and lateral head of the triceps brachii on the posterior aspect of the arm.

Standard 110503

Extended 110503

POSITION

Prone.

INCISION

A curved incision along the posterior border of the deltoid with a linear incision between the lateral and long head of the triceps brachii.

REFERENCES

  1. Tung TH, Mackinnon SE. Nerve transfers: indications, techniques, and outcomes. J Hand Surg Am. 2010 Feb;35(2):332-41. Review. PMID: 20141906.
  2. Ray WZ, Mackinnon SE. Management of nerve gaps: autografts, allografts, nerve transfers, and end-to-side neurorrhaphy. Exp Neurol. 2010 May;223(1):77-85. Review. PMID: 19348799.
  3. Colbert SH, Mackinnon SE. Nerve transfers for brachial plexus reconstruction. Hand Clin. 2008 Nov;24(4):341-61, v. Review. PMID: 18928885.
  4. Mackinnon SE, Colbert SH. Nerve transfers in the hand and upper extremity surgery. Tech Hand Up Extrem Surg. 2008 Mar;12(1):20-33. Review. PMID: 18388751.
  5. Pannucci C, Myckatyn TM, Mackinnon SE, Hayashi A. End-to-side nerve repair: review of the literature. Restor Neurol Neurosci. 2007;25(1):45-63. Review. PMID: 17473395.
  6. Walker JC, Brenner MJ, Mackinnon SE, Winograd JM, Hunter DA. Effect of perineurial window size on nerve regeneration, blood-nerve barrier integrity, and functional recovery. J Neurotrauma. 2004 Feb;21(2):217-27. PMID: 15000762.
  7. Goheen-Robillard B, Myckatyn TM, Mackinnon SE, Hunter DA. End-to-side neurorrhaphy and lateral axonal sprouting in a long graft rat model. Laryngoscope. 2002 May;112(5):899-905. PMID: 12150625.
  8. Tarasidis G, Watanabe O, Mackinnon SE, Strasberg SR, Haughey BH, Hunter DA. End-to-side neurorraphy: a long-term study of neural regeneration in a rat model. Otolaryngol Head Neck Surg. 1998 Oct;119(4):337-41. PMID: 9781986.
  9. Tarasidis G, Watanabe O, Mackinnon SE, Strasberg SR, Haughey BH, Hunter DA. End-to-side neurorrhaphy resulting in limited sensory axonal regeneration in a rat model. Ann Otol Rhinol Laryngol. 1997 Jun;106(6):506-12. PMID: 9199612.

Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

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