{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T15:06:15Z","timestamp":1774019175179,"version":"3.50.1"},"reference-count":32,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n In the treatment of obstetric brachial plexus palsy (OBPP), neurotization, or nerve transfer, has become a crucial microsurgical procedure, especially when nerve roots are avulsed or non-functional. To reinnervate a denervated target and restore motor function, a functional donor neuron must be redirected. The objective of the study is to assess the outcomes of various neurotization approaches in individuals with brachial plexus injuries sustained during pregnancy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Thirty patients with OBPP who received microsurgical treatment using various brachial plexus neurotization procedures at Menoufia University Hospital between January 2018 and January 2024, with postoperative follow-up for at least 18 months, were included in this nonrandomized prospective study. Intraplexal neurotization used the existing healthy root stumps, which were ruptured for reconstruction by joining them with the distal target trunks, cords, or nerves using nerve grafts. The extraplexal neurotization was done by extraplexal nerves, such as the spinal accessory nerve, intercostal nerves, and\/or contralateral C7 root.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The outcome of different joint movements showed improvement of the shoulder (good:\n n<\/jats:italic>\n = 25, 83.33%) better than in the elbow (good:\n n<\/jats:italic>\n = 20, 66.67%), while the finger movement showed the least improvement (good:\n n<\/jats:italic>\n = 17, 56.67%). The suprascapular nerve neurotization outcome by spinal accessory nerve showed\n n<\/jats:italic>\n = 28, 94.4% good outcome and\n n<\/jats:italic>\n = 2, 5.6% fair outcome which were better than outcome by C5 root neurotization (\n n<\/jats:italic>\n = 20, 66.7% good and\n n<\/jats:italic>\n = 10, 33.3% fair).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n When a nerve source is present in the damaged plexus, intraplexal neurotization is utilized; if not, extraplexal nerve sources may be utilized. Results from spinal accessory nerve neurotization of the suprascapular nerve are superior to those from intraplexal neurotization.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_572_2025","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:33:15Z","timestamp":1774013595000},"page":"157","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurotization in microsurgical repair of obstetric brachial plexus palsy: Surgical outcome of different techniques"],"prefix":"10.25259","volume":"17","author":[{"given":"Yasser Bahgat","family":"Elsisi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Fathy","family":"Sheha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeed Ismaeel","family":"Aleemam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossam","family":"Elnoamany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Gabry","family":"Elnaggar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"10.25259\/SNI_572_2025\/ref-1","article-title":"Pattern of Birth-Related Brachial Plexus Injuries (Doctoral Dissertation, Department of Physiotherapy, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana)","author":"Addo","year":"2022"},{"key":"10.25259\/SNI_572_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1302\/0301-620X.87B8.15975","article-title":"Repair of obstetric brachial plexus palsy: Results in 100 children","volume":"87","author":"Birch","year":"2005","journal-title":"J Bone Joint Surg Br"},{"key":"10.25259\/SNI_572_2025\/ref-3","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/01.PRS.0000169936.19073.B4","article-title":"Surgical strategy for infant obstetrical brachial plexus palsy: Experiences at Chang gung memorial hospital","volume":"116","author":"Chuang","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_572_2025\/ref-4","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1177\/147323001204000429","article-title":"Changes in spontaneous dorsal horn potentials after dorsal root entry zone lesioning in patients with pain after brachial plexus avulsion","volume":"40","author":"Dong","year":"2012","journal-title":"J Int Med Res"},{"key":"10.25259\/SNI_572_2025\/ref-5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/micr.20726","article-title":"Total obstetric brachial plexus palsy: Results and strategy of microsurgical reconstruction","volume":"30","author":"El-gammal","year":"2010","journal-title":"Microsurgery"},{"key":"10.25259\/SNI_572_2025\/ref-6","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0749-0712(21)00266-3","article-title":"Long-term evaluation of brachial plexus surgery in obstetrical palsy","volume":"11","author":"Gilbert","year":"1995","journal-title":"Hand Clin"},{"key":"10.25259\/SNI_572_2025\/ref-7","doi-asserted-by":"crossref","first-page":"34","DOI":"10.4103\/0970-0358.16494","article-title":"Primary repair of the obstetrical plexus","volume":"38","author":"Gilbert","year":"2005","journal-title":"Indian J Plast Surg"},{"key":"10.25259\/SNI_572_2025\/ref-8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4103\/1110-2098.132795","article-title":"Suprascapular nerve neurotization in obstetrical brachial plexus palsy using the spinal accessory nerve or the C5 root","volume":"27","author":"Hanafey","year":"2014","journal-title":"Menoufia Med J"},{"issue":"2","key":"10.25259\/SNI_572_2025\/ref-9","first-page":"85","article-title":"Nerve grafting versus nerve transfers for restoration of shoulder and elbow function after traumatic brachial plexus palsy","volume":"18","author":"Hassan","year":"2024","journal-title":"Minia J Med Res"},{"key":"10.25259\/SNI_572_2025\/ref-10","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/00003086-198702000-00034","article-title":"Early microsurgical reconstruction in birth palsy","volume":"215","author":"Kawabata","year":"1987","journal-title":"Clin Orthop Relat Res"},{"key":"10.25259\/SNI_572_2025\/ref-11","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/0363-5023(94)90196-1","article-title":"Intercostal nerve transfer for brachial plexopathy","volume":"19","author":"Krakauer","year":"1994","journal-title":"J Hand Surg Am"},{"key":"10.25259\/SNI_572_2025\/ref-12","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1097\/01.PRS.0000049110.65510.10","article-title":"Complications of microsurgical reconstruction of obstetrical brachial plexus palsy","volume":"111","author":"La Scala","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_572_2025\/ref-13","doi-asserted-by":"crossref","first-page":"1359719","DOI":"10.3389\/fsurg.2024.1359719","article-title":"Global trends in surgical approach to neonatal brachial plexus palsy: A systematic review","volume":"11","author":"Levidy","year":"2025","journal-title":"Front Surg"},{"key":"10.25259\/SNI_572_2025\/ref-14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-030-69517-0_1","article-title":"Adult brachial plexus injuries: A historical perspective","volume-title":"Operative Brachial Plexus Surgery: Clinical Evaluation and Management Strategies","author":"Lu","year":"2021"},{"key":"10.25259\/SNI_572_2025\/ref-15","first-page":"141","article-title":"Nerve surgery for neonatal brachial plexus palsy","volume":"4","author":"Malessy","year":"2011","journal-title":"J Pediatr Rehabil Med"},{"key":"10.25259\/SNI_572_2025\/ref-16","doi-asserted-by":"crossref","first-page":"6186","DOI":"10.3390\/jcm13206186","article-title":"Systematic review and meta-analysis of intervention techniques in occupational therapy for babies and children with obstetric brachial plexus palsy","volume":"13","author":"Mart\u00ednez-Carl\u00f3n-Reina","year":"2024","journal-title":"J Clin Med"},{"key":"10.25259\/SNI_572_2025\/ref-17","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1055\/s-2004-837261","article-title":"Obstetrical brachial plexus palsy: The Istanbul experience","volume":"18","author":"Mersa","year":"2004","journal-title":"Semin Plast Surg"},{"key":"10.25259\/SNI_572_2025\/ref-18","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1097\/00006534-199404000-00001","article-title":"The natural history of obstetrical brachial plexus palsy","volume":"93","author":"Michelow","year":"1994","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_572_2025\/ref-19","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1080\/09638288.2022.2080287","article-title":"Brachial plexus injury: Living with uncertainty","volume":"45","author":"Miller","year":"2023","journal-title":"Disabil Rehabil"},{"key":"10.25259\/SNI_572_2025\/ref-20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.4103\/err.err_4_19","article-title":"Evaluation of surgical outcomes of obstetric brachial plexus birth injury: Clinical and electrophysiological study","volume":"46","author":"Mohasseb","year":"2019","journal-title":"Egypt Rheumatol Rehabil"},{"key":"10.25259\/SNI_572_2025\/ref-21","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/0363-5023(92)90450-4","article-title":"Restoration of elbow flexion in root lesions of brachial plexus injuries","volume":"17","author":"Nagano","year":"1992","journal-title":"J Hand Surg Am"},{"key":"10.25259\/SNI_572_2025\/ref-22","first-page":"e54","article-title":"Successful outcome of modified quad surgical procedure in preteen and teen patients with brachial plexus birth palsy","volume":"12","author":"Nath","year":"2012","journal-title":"Eplasty"},{"key":"10.25259\/SNI_572_2025\/ref-23","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1111\/j.1471-0528.2011.02942.x","article-title":"Correlating birthweight with neurological severity of obstetric brachial plexus lesions","volume":"118","author":"Pondaag","year":"2011","journal-title":"BJOG Int J Obstet Gynaecol"},{"key":"10.25259\/SNI_572_2025\/ref-24","doi-asserted-by":"crossref","first-page":"411","DOI":"10.6061\/clinics\/2013(03)R02","article-title":"What has changed in brachial plexus surgery?","volume":"68","author":"Rezende","year":"2013","journal-title":"Clinics (Sao Paulo)"},{"key":"10.25259\/SNI_572_2025\/ref-25","doi-asserted-by":"crossref","first-page":"54E","DOI":"10.1097\/01.PRS.0000110215.61220.72","article-title":"The surgical treatment of obstetric brachial plexus palsy","volume":"113","author":"Shenaq","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"10.25259\/SNI_572_2025\/ref-26","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s00381-015-2971-4","article-title":"Obstetric brachial plexus palsy: Reviewing the literature comparing the results of primary versus secondary surgery","volume":"32","author":"Socolovsky","year":"2016","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_572_2025\/ref-27","doi-asserted-by":"crossref","first-page":"e265","DOI":"10.1016\/j.wneu.2024.08.103","article-title":"surgical repair of obstetric brachial plexus injuries: A case series and discussion of the current literature","volume":"191","author":"Taylor","year":"2024","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_572_2025\/ref-28","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1055\/s-2005-867112","article-title":"Radiological and electrophysiological detection of nerve roots avulsion in patients with birth-related brachial plexus paralysis","volume":"19","author":"Terzis","year":"2005","journal-title":"Semin Plast Surg"},{"key":"10.25259\/SNI_572_2025\/ref-29","first-page":"2","article-title":"Obstetric brachial plexus palsy. Diagnosis and management strategy","volume":"1","author":"Thatte","year":"2017","journal-title":"J Peripher Nerve Surg"},{"key":"10.25259\/SNI_572_2025\/ref-30","first-page":"40","article-title":"Remote therapeutic effect of early nerve transposition in the treatment of obstetric brachial plexus palsy","volume":"4","author":"Xu","year":"2001","journal-title":"Chin J Traumatol"},{"key":"10.25259\/SNI_572_2025\/ref-31","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1053\/j.semperi.2014.04.009","article-title":"Neonatal brachial plexus palsy--management and prognostic factors","volume":"38","author":"Yang","year":"2014","journal-title":"Semin Perinatol"},{"key":"10.25259\/SNI_572_2025\/ref-32","doi-asserted-by":"crossref","first-page":"609","DOI":"10.5152\/j.aott.2020.19180","article-title":"A retrospective analysis of risk factors for clavicle fractures in newborns with shoulder dystocia and brachial plexus injury: A single-center experience","volume":"54","author":"Yenig\u00fcl","year":"2020","journal-title":"Acta Orthop Traumatol Turc"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/neurotization-in-microsurgical-repair-of-obstetric-brachial-plexus-palsy-surgical-outcome-of-different-techniques\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/neurotization-in-microsurgical-repair-of-obstetric-brachial-plexus-palsy-surgical-outcome-of-different-techniques\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T13:33:19Z","timestamp":1774013599000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/neurotization-in-microsurgical-repair-of-obstetric-brachial-plexus-palsy-surgical-outcome-of-different-techniques\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":32,"alternative-id":["10.25259\/SNI_572_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_572_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,20]]},"article-number":"157"}}