Dissection of intercostal nerves by means of assisted video thoracoscopy: experimental study.

In total brachial plexus preganglionic lesions (C5-C6-C7-C8 and T1) different extraplexual neurotizations are indicated for partial motor function restitution. Mostly for the flexion of the elbow. Neurotization with intercostal nerves (ICN) to musculocutaneous nerve has been known and accepted during many years with different results 2 - 5.

Neurotization with the brachialis muscle motor nerve.

Function of the wrist and hand in lower root avulsions is severely impaired. Based on anatomic and experimental studies which suggest that the motor nerve of the brachialis muscle could be used as a selective neurotizator in lower root avulsions with intact C5-C6 +/- C7 roots (Klumpke paralysis), we considered its use depending on the target. We describe two techniques for the median nerve (in C8-T1 avulsions) and one for the radial nerve (in C7-C8-T1 avulsions).