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Wen-Dong Xu, Yu-Dong Gu, Jing-Bo Liu, Cong Yu, Cheng-Gang Zhang and Jian-Guang Xu

P hrenic nerve transfer is a commonly performed surgical procedure to treat brachial plexus injuries in which the nerve root is totally avulsed. 4, 9, 15, 17 The deterioration of pulmonary function following this surgical procedure has been of concern to plastic surgeons, 2, 11 cardiac surgeons, and organ transplantation surgeons 5, 13 because the phrenic nerve may be accidentally injured during the surgery. 5, 13 Authors of an increasing number of studies have suggested that phrenic nerve transfer surgery actually may not harm pulmonary function in the

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Wen-Dong Xu, Jiu-Zhou Lu, Yan-Qun Qiu, Su Jiang, Lei Xu, Jian-Guang Xu and Yu-Dong Gu

T he treatment of complete BPAI is a demanding and difficult surgery in the upper extremity. Currently, nerve transfer is the main method of treating BPAI. 22 However, the traditional means of nerve transfer lead to poor functional recovery of hand prehension, mainly attributable to the long distance between the nerve anastomosis site and the reinnervated antebrachial muscle. TABLE 1 Complete brachial plexus avulsion injury in 3 patients treated with full-length PN transfer to the medial root of the median nerve

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Chuan-Tao Zuo, Xu-Yun Hua, Yi-Hui Guan, Wen-Dong Xu, Jian-Guang Xu and Yu-Dong Gu

the same hemisphere, there can be long-range plasticity between cortical hemispheres. Most of the evidence comes from studies of direct cortical damage, such as stroke or cortical lesions in human and animal models. 1 , 4 , 8 , 25 Some studies have also explored interhemispheric cortical plasticity after peripheral nerve deafferentation, but little long-term motor cortex plasticity was involved. Brachial plexus root avulsion injury is a severe peripheral nerve deafferentation in which the nerves that bridge the CNS and one side of the upper limb are ruptured. The

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Xu-Yun Hua, Bin Liu, Yan-Qun Qiu, Wei-Jun Tang, Wen-Dong Xu, Han-Qiu Liu, Jian-Guang Xu and Yu-Dong Gu

approved by the Medical Committee. All patients had complete avulsion of the 5 roots of the upper limb diagnosed by clinical evaluation and electromyography studies before surgery. During the surgical treatment the whole brachial plexus was exposed, and a definitive diagnosis of root avulsions was made at operation because the C5–T1 nerve within the intervertebral foramen was absent. The nerve transfer operation was performed with contralateral C-7 root to the median nerve of the damaged brachial plexus. The ulnar nerve of the damaged limb was used to perform grafting

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Mou-Xiong Zheng, Xu-Yun Hua, Su Jiang, Yan-Qun Qiu, Yun-Dong Shen and Wen-Dong Xu

rhesus monkeys) has been used as a donor nerve for treating lumbosacral plexus avulsion or atonic bladder due to conus medullaris injury. 10 , 12 , 21 Second, the L-6 nerve is located in the middle of the sacral plexus nerves in rodents, just as the C-7 nerve is in the brachial plexus nerves. It was inferred that the L-6 nerve also overlapped with neighboring nerves and could readily compensate. Additionally, as the surgical procedure of L6-L6 could be completed intraspinally distal to the conus medullaris and performed directly, nerve grafts could be avoided

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Xuan Ye, Yun-Dong Shen, Jun-Tao Feng and Wen-Dong Xu

injured SAN, and we evaluate the efficacy of the technique postoperatively. The technique, first performed in cadavers, was then undertaken in two patients. Methods Applied Anatomical Study Six fresh adult cadavers (4 males and 2 females; age range at death 50–65 years) were dissected ( Fig. 1 ). The SAN was explored carefully from the jugular foramen to the medial border of the trapezius muscle, and the brachial plexus was also explored from the intervertebral foramen to its divisions. We measured the length of donor nerve fascicle from artificial bifurcation (the site

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Guo-Bao Wang, Ai-Ping Yu, Chye Yew Ng, Gao-Wei Lei, Xiao-Min Wang, Yan-Qun Qiu, Jun-Tao Feng, Tie Li, Qing-Zhong Chen, Qian-Ru He, Fei Ding, Shu-Sen Cui, Yu-Dong Gu, Jian-Guang Xu, Su Jiang and Wen-Dong Xu

I n 1992, Gu et al. 11 reported the concept and clinical application of using a healthy contralateral C7 (CC7) nerve root as donor nerve in reconstruction of the brachial plexus for treatment of total brachial plexus palsy (TBPP). Since then CC7 nerve transfer has gained wider acceptability, with promising results reported from other centers. 6 , 26 , 28 , 29 , 31–34 Apart from TBPP, the utility of CC7 has also been expanded to the treatment of patients with central neurological injuries, such as cerebral palsy, traumatic brain injury, and stroke. 14 , 37 , 39