Clinical and Electrophysiological Assessment of Functional Recovery Following Nerve Transfer for Brachial Plexus Injuries | ||||
| Zagazig University Medical Journal | ||||
| Articles in Press, Accepted Manuscript, Available Online from 19 July 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2025.396539.4016 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Enass A. Eliwa1; Yassir A.A. Mohammad1; Mohammad -Reda Ahmad2; Eman Emad El-Din Abdel-Azim  3
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| 1Professor of Rheumatology and Rehabilitation, Faculty of Medicine, Zagazig University | ||||
| 2Professor of Plastic Reconstructive Surgery, Faculty of Medicine, Zagazig University | ||||
| 3Resident Doctor at Rheumatology and Rehabilitation Department, Zagazig University Hospitals | ||||
| Abstract | ||||
| Background: Brachial plexus injuries (BPI) can lead to significant disability, especially in children with obstetric causes or adults with traumatic origins. Early nerve transfer surgery combined with structured rehabilitation is a key intervention. Electrophysiological studies, as compound muscle action potential (CMAP) and EMG, may offer early insights into nerve regeneration and functional recovery. This work aimed to evaluate both the clinical and electrophysiological outcomes in patients with BPI following nerve transfer surgery, and to explore correlations between these outcomes. Methods: This prospective cohort study included 18 patients (median age 2 years, range 1–60; 55.6% males) with BPI who underwent nerve transfer surgery at Zagazig University Hospitals. Main procedures were spinal accessory nerve (SAN) to suprascapular nerve (SSN) transfer (77.8%), intercostal nerve (ICN) to musculocutaneous nerve (MCN) transfer (61.1%), and Oberlin transfer (22.2%). Clinical outcomes were measured using the Modified Mallet score and Medical Research Council (MRC), and electrophysiological outcomes were assessed by CMAP amplitude and motor unit recruitment over 9 months. Results: Both Modified Mallet scores (from 11.22 ± 4.89 to 18.17 ± 7.04, P < 0.001) and MRC grades (from 1.61 ± 0.5 to 2.89 ± 1.45, P < 0.001) improved significantly at 9 months. The CMAP amplitude increased by 195.7% postoperatively (from 2.78 ± 0.29 to 8.22 ± 3.88, P < 0.001). Conclusions: Early nerve transfer surgery led to significant functional and electrophysiological improvement in BPI patients, especially when performed within nine months of injury. CMAP amplitude served as a valuable early predictor of clinical recovery. | ||||
| Keywords | ||||
| Electrophysiological Assessment; Clinical; Functional Recovery; Nerve Transfer; Brachial Plexus Injuries | ||||
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