{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:18:40Z","timestamp":1788265120362,"version":"build-2803163510"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Triceps motor branch transfer to the anterior division of the axillary nerve (AXN) was originally described for patients with a loss of deltoid function secondary to upper trunk (UT) brachial plexus injuries but has evolved to restore deltoid function in isolated peripheral AXN injuries. The purpose of this study was to compare functional outcomes in patients who had undergone this procedure in the setting of UT brachial plexus injury versus peripheral AXN injury.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The records of patients who had undergone triceps branch to anterior division of the AXN transfer at a single academic institution between 2001 and 2023 were retrospectively reviewed. Patients were included in the study if they had either a UT or an AXN injury and were excluded if their follow-up was less than 2 years. Pre- and postoperative outcomes, including modified British Medical Research Council grade and range of motion, were compared between the two groups.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Forty-two patients met the criteria for inclusion. Thirty cases were classified as UT injury and 12 cases as AXN injury. The mean postoperative abduction strength was significantly higher in the AXN injury group (3.2 \u00b1 1.5 vs 1.9 \u00b1 1.2, p = 0.007), as was the postoperative change in abduction strength (2.8 \u00b1 1.7 vs 1.6 \u00b1 1.4, p = 0.01). The mean postoperative forward flexion (136\u00b0 \u00b1 57\u00b0 vs 79\u00b0 \u00b1 54\u00b0, p = 0.005) and abduction (129\u00b0 \u00b1 64\u00b0 vs 59\u00b0 \u00b1 47\u00b0, p = 0.004) were significantly better in the AXN group, although postoperative changes in flexion and abduction were not different between the groups. Triceps strength preoperatively was similar to that postoperatively in both groups.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Patients with an AXN injury, compared to those with a UT injury, had better postoperative abduction strength and shoulder range of motion after triceps branch transfer to the anterior division of the AXN. Triceps strength was not significantly changed after the procedure in the two groups. The study findings suggest that the outcomes of triceps branch transfer to the anterior division of the AXN are different based on the location and type of injury, providing insight into prognosis while counseling patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.1.focus24890","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T04:34:29Z","timestamp":1743654869000},"page":"E5","source":"Crossref","is-referenced-by-count":2,"title":["A comparison of functional outcomes for triceps motor branch transfer to the anterior division axillary nerve in upper trunk brachial plexus injuries versus non\u2013brachial plexus axillary nerve injuries"],"prefix":"10.3171","volume":"58","author":[{"given":"Mikaela H.","family":"Sullivan","sequence":"first","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava G.","family":"Chappell","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Spinner","sequence":"additional","affiliation":[{"name":"Neurosurgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Pulos","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen T.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Y.","family":"Shin","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"J Bone Joint Surg Am","first-page":"819","article-title":"Comparison of nerve transfers and nerve grafting for traumatic upper plexus palsy: a systematic review and analysis","volume":"93","author":"Garg R","year":"2011","unstructured":"Garg R, Merrell GA, Hillstrom HJ, Wolfe SW. Comparison of nerve transfers and nerve grafting for traumatic upper plexus palsy: a systematic review and analysis. J Bone Joint Surg Am. 2011;93(9):819\u2013829."},{"issue":"3","key":"b2","series-title":"Plast Reconstr Surg","first-page":"545","article-title":"Five operations that give the best results after brachial plexus injury","volume":"140","author":"Maldonado AA","year":"2017","unstructured":"Maldonado AA, Bishop AT, Spinner RJ, Shin AY. Five operations that give the best results after brachial plexus injury. Plast Reconstr Surg. 2017;140(3):545\u2013556."},{"issue":"4","key":"b3","series-title":"J Hand Surg Am","first-page":"633","article-title":"Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: a report of 7 cases","volume":"28","author":"Leechavengvongs S","year":"2003","unstructured":"Leechavengvongs S, Witoonchart K, Uerpairojkit C, Thuvasethakul P. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: a report of 7 cases. J Hand Surg Am. 2003;28(4):633\u2013638."},{"issue":"4","key":"b4","series-title":"J Hand Surg Am","first-page":"628","article-title":"Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study","volume":"28","author":"Witoonchart K","year":"2003","unstructured":"Witoonchart K, Leechavengvongs S, Uerpairojkit C, Thuvasethakul P, Wongnopsuwan V. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study. J Hand Surg Am. 2003;28(4):628-632."},{"issue":"2","key":"b5","series-title":"J Hand Surg Am","first-page":"183","article-title":"Combined nerve transfers for C5 and C6 brachial plexus avulsion injury","volume":"31","author":"Leechavengvongs S","year":"2006","unstructured":"Leechavengvongs S, Witoonchart K, Uerpairojkit C, Thuvasethakul P, Malungpaishrope K. Combined nerve transfers for C5 and C6 brachial plexus avulsion injury. J Hand Surg Am. 2006;31(2):183\u2013189."},{"issue":"VideoSuppl1","key":"b6","series-title":"Neurosurg Focus","first-page":"V1","article-title":"Radial to axillary nerve transfer","volume":"44","author":"Vanaclocha V","year":"2018","unstructured":"Vanaclocha V, Herrera JM, Rivera-Paz M, Mart\u00ednez-G\u00f3mez D, Vanaclocha L. Radial to axillary nerve transfer. Neurosurg Focus. 2018;44(VideoSuppl1):V1."},{"issue":"11","key":"b7","series-title":"J Hand Surg Am","first-page":"1168.e1","article-title":"Posterior deltoid function after transfer of branch to the long head triceps brachii of the radial nerve to the anterior branch of the axillary nerve","volume":"48","author":"Anantavorasakul N","year":"2023","unstructured":"Anantavorasakul N, Piakong P, Kittithamvongs P, Malungpaishrope K, Uerpairojkit C, Leechavengvongs S. Posterior deltoid function after transfer of branch to the long head triceps brachii of the radial nerve to the anterior branch of the axillary nerve. J Hand Surg Am. 2023;48(11):1168.e1\u20131168.e6."},{"issue":"11","key":"b8","series-title":"J Hand Surg Am","first-page":"2350","article-title":"Factors affecting outcome of triceps motor branch transfer for isolated axillary nerve injury","volume":"37","author":"Lee JY","year":"2012","unstructured":"Lee JY, Kircher MF, Spinner RJ, Bishop AT, Shin AY. Factors affecting outcome of triceps motor branch transfer for isolated axillary nerve injury. J Hand Surg Am. 2012;37(11):2350\u20132356."},{"issue":"10","key":"b9","series-title":"By Michael O\u2019Brien for the Guarantors of Brain","first-page":"2838","article-title":"Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee","volume":"133","author":"Compston A","year":"2010","unstructured":"Compston A. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty\u2019s Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O\u2019Brien for the Guarantors of Brain.Saunders Elsevier:2010;pp.[8] 64 and 94 Figures. Brain. 2010;133(10):2838-2844."},{"issue":"4","key":"b10","series-title":"J Neurosurg Spine","first-page":"515","article-title":"Inter-rater reliability of the modified Medical Research Council scale in patients with chronic incomplete spinal cord injury","volume":"30","author":"Dup\u00e9p\u00e9 EB","year":"2019","unstructured":"Dup\u00e9p\u00e9 EB, Davis M, Elsayed GA, Inter-rater reliability of the modified Medical Research Council scale in patients with chronic incomplete spinal cord injury. J Neurosurg Spine. 2019;30(4):515\u2013519."},{"issue":"9","key":"b11","series-title":"Plast Reconstr Surg Glob Open","first-page":"e3096","article-title":"Radial to axillary nerve transfer outcomes in shoulder abduction: a systematic review","volume":"8","author":"Wells ME","year":"2020","unstructured":"Wells ME, Gonzalez GA, Childs BR, Williams MR, Nesti LJ, Dunn JC. Radial to axillary nerve transfer outcomes in shoulder abduction: a systematic review. Plast Reconstr Surg Glob Open. 2020;8(9):e3096."},{"issue":"5","key":"b12","series-title":"Plast Reconstr Surg","first-page":"1470","article-title":"Evaluation of single-, double-, and triple-nerve transfers for shoulder abduction in 90 patients with supraclavicular brachial plexus injury","volume":"122","author":"Cardenas-Mejia A","year":"2008","unstructured":"Cardenas-Mejia A, O\u2019Boyle CP, Chen KT, Chuang DC. Evaluation of single-, double-, and triple-nerve transfers for shoulder abduction in 90 patients with supraclavicular brachial plexus injury. Plast Reconstr Surg. 2008;122(5):1470\u20131478."},{"issue":"9","key":"b1","series-title":"J Bone Joint Surg Am","first-page":"819","article-title":"Comparison of nerve transfers and nerve grafting for traumatic upper plexus palsy: a systematic review and analysis","volume":"93","author":"Garg R","year":"2011","unstructured":"Garg R, Merrell GA, Hillstrom HJ, Wolfe SW. Comparison of nerve transfers and nerve grafting for traumatic upper plexus palsy: a systematic review and analysis. J Bone Joint Surg Am. 2011;93(9):819\u2013829."},{"issue":"3","key":"b2","series-title":"Plast Reconstr Surg","first-page":"545","article-title":"Five operations that give the best results after brachial plexus injury","volume":"140","author":"Maldonado AA","year":"2017","unstructured":"Maldonado AA, Bishop AT, Spinner RJ, Shin AY. Five operations that give the best results after brachial plexus injury. Plast Reconstr Surg. 2017;140(3):545\u2013556."},{"issue":"4","key":"b3","series-title":"J Hand Surg Am","first-page":"633","article-title":"Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: a report of 7 cases","volume":"28","author":"Leechavengvongs S","year":"2003","unstructured":"Leechavengvongs S, Witoonchart K, Uerpairojkit C, Thuvasethakul P. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: a report of 7 cases. J Hand Surg Am. 2003;28(4):633\u2013638."},{"issue":"4","key":"b4","series-title":"J Hand Surg Am","first-page":"628","article-title":"Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study","volume":"28","author":"Witoonchart K","year":"2003","unstructured":"Witoonchart K, Leechavengvongs S, Uerpairojkit C, Thuvasethakul P, Wongnopsuwan V. Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: an anatomic feasibility study. J Hand Surg Am. 2003;28(4):628-632."},{"issue":"2","key":"b5","series-title":"J Hand Surg Am","first-page":"183","article-title":"Combined nerve transfers for C5 and C6 brachial plexus avulsion injury","volume":"31","author":"Leechavengvongs S","year":"2006","unstructured":"Leechavengvongs S, Witoonchart K, Uerpairojkit C, Thuvasethakul P, Malungpaishrope K. Combined nerve transfers for C5 and C6 brachial plexus avulsion injury. J Hand Surg Am. 2006;31(2):183\u2013189."},{"issue":"VideoSuppl1","key":"b6","series-title":"Neurosurg Focus","first-page":"V1","article-title":"Radial to axillary nerve transfer","volume":"44","author":"Vanaclocha V","year":"2018","unstructured":"Vanaclocha V, Herrera JM, Rivera-Paz M, Mart\u00ednez-G\u00f3mez D, Vanaclocha L. Radial to axillary nerve transfer. Neurosurg Focus. 2018;44(VideoSuppl1):V1."},{"issue":"11","key":"b7","series-title":"J Hand Surg Am","first-page":"1168.e1","article-title":"Posterior deltoid function after transfer of branch to the long head triceps brachii of the radial nerve to the anterior branch of the axillary nerve","volume":"48","author":"Anantavorasakul N","year":"2023","unstructured":"Anantavorasakul N, Piakong P, Kittithamvongs P, Malungpaishrope K, Uerpairojkit C, Leechavengvongs S. Posterior deltoid function after transfer of branch to the long head triceps brachii of the radial nerve to the anterior branch of the axillary nerve. J Hand Surg Am. 2023;48(11):1168.e1\u20131168.e6."},{"issue":"11","key":"b8","series-title":"J Hand Surg Am","first-page":"2350","article-title":"Factors affecting outcome of triceps motor branch transfer for isolated axillary nerve injury","volume":"37","author":"Lee JY","year":"2012","unstructured":"Lee JY, Kircher MF, Spinner RJ, Bishop AT, Shin AY. Factors affecting outcome of triceps motor branch transfer for isolated axillary nerve injury. J Hand Surg Am. 2012;37(11):2350\u20132356."},{"issue":"10","key":"b9","series-title":"By Michael O\u2019Brien for the Guarantors of Brain","first-page":"2838","article-title":"Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee","volume":"133","author":"Compston A","year":"2010","unstructured":"Compston A. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty\u2019s Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O\u2019Brien for the Guarantors of Brain.Saunders Elsevier:2010;pp.[8] 64 and 94 Figures. Brain. 2010;133(10):2838-2844."},{"issue":"4","key":"b10","series-title":"J Neurosurg Spine","first-page":"515","article-title":"Inter-rater reliability of the modified Medical Research Council scale in patients with chronic incomplete spinal cord injury","volume":"30","author":"Dup\u00e9p\u00e9 EB","year":"2019","unstructured":"Dup\u00e9p\u00e9 EB, Davis M, Elsayed GA, Inter-rater reliability of the modified Medical Research Council scale in patients with chronic incomplete spinal cord injury. J Neurosurg Spine. 2019;30(4):515\u2013519."},{"issue":"9","key":"b11","series-title":"Plast Reconstr Surg Glob Open","first-page":"e3096","article-title":"Radial to axillary nerve transfer outcomes in shoulder abduction: a systematic review","volume":"8","author":"Wells ME","year":"2020","unstructured":"Wells ME, Gonzalez GA, Childs BR, Williams MR, Nesti LJ, Dunn JC. Radial to axillary nerve transfer outcomes in shoulder abduction: a systematic review. Plast Reconstr Surg Glob Open. 2020;8(9):e3096."},{"issue":"5","key":"b12","series-title":"Plast Reconstr Surg","first-page":"1470","article-title":"Evaluation of single-, double-, and triple-nerve transfers for shoulder abduction in 90 patients with supraclavicular brachial plexus injury","volume":"122","author":"Cardenas-Mejia A","year":"2008","unstructured":"Cardenas-Mejia A, O\u2019Boyle CP, Chen KT, Chuang DC. Evaluation of single-, double-, and triple-nerve transfers for shoulder abduction in 90 patients with supraclavicular brachial plexus injury. Plast Reconstr Surg. 2008;122(5):1470\u20131478."}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/58\/4\/article-pE5.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/58\/4\/article-pE5.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/58\/4\/article-pE5.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:23:27Z","timestamp":1780734207000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/58\/4\/article-pE5.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":24,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2025.1.focus24890","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}