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Intercostal Nerve Transfer in Management of Biceps and Triceps Co-contraction in Spontaneously Recovered Obstetric Brachial Plexus Injury
Ahmad Semaya, MD; Mohammed Hassan, MD; Ramy El-Nakeeb
Orthopedics, Alexandria University, Alexandria, Egypt

Biceps and triceps co-contraction may occur in spontaneously recovered obstetrical brachial plexus injury due to cross reinnervation. Such co-contraction of the biceps and the triceps impairs normal elbow motion and makes it difficult to use the elbow in normal daily activities despite adequate strength in these muscles. We present 15 patients with biceps and triceps co-contraction in spontaneously recovered obstetric brachial plexus injury. They were treated with intercostal nerve transfer to the musculocutaneous nerve without any exploration or dissection of the remaining plexus from June 2005 to March 2009. There were 9 males and 6 females. The mean age at surgery was 15 months (range from 13 to 24). Preoperative electrodiagnosis EMG was used in all cases. The mean postoperative follow-up period was 22 months (range from 19 to 37). At the final follow up, 12 (80 %) patients had good results (M4 to M5). The other (20 %) patients had poor results (M2 to M3). Intercostal nerves transfer to musculocutaneous nerve for treatment of biceps and triceps co-contraction achieved satisfactory results in 80% of the cases.


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