Acta clinica Croatica, Vol. 65. No. 1, 2026.
Review article
https://doi.org/10.20471/acc.2026.65.01.14
Transfer of the Medial Pectoral and Thoracodorsal Nerve in Cases with Upper Brachial Plexus Palsy: Controversies, Problems and Solutions
Novak Lakićević
; Clinic for Neurosurgery, Clinical Center of Montenegro, Podgorica, Montenegro; Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
*
Slavko Đurašković
; Clinic for Neurosurgery, Clinical Center of Montenegro, Podgorica, Montenegro; Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
Sanja Medenica
; Faculty of Medicine, University of Montenegro, Podgorica, Montenegro; Institute for Public Health of Montenegro, Podgorica, Montenegro
Lukas Rasulić
; Clinic for Neurosurgery, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Miroslav Samardžić
; Clinic for Neurosurgery, University Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
* Corresponding author.
Abstract
Two main priorities in restoring arm functions in brachial plexus injuries, re-
gardless of their extension, are elbow flexion and shoulder functions. In cas-
es with directly irreparable nerve injuries, nerve transfer is the only option for
functional reconstruction. Nerve transfers have been attempted using differ-
ent extraplexal and/or intraplexal donor nerves. Fortunately, in cases of upper
brachial plexus palsy involving the C5, C6 and in some cases C7 spinal nerves,
there is a wider choice of donors that include intraplexal collateral branches,
fascicles of the ulnar and median nerves, and the triceps branches of the radi-
al nerve. Our experiences are based on the use of the medial pectoral (MPN)
and thoracodorsal (TDN) nerves, which could be used in the restoration of both
functions, even simultaneously. The aim of this review, aside from an evaluation
of already published results, is a discussion regarding controversies, some tech-
nical problems and their solutions. The main conclusion is that these transfers
could be reliable methods in the restoration of upper arm functions, used both
separately and in combination with other types of nerve transfers.
Keywords
Brachial plexus; Donor nerves; Medial pectoral nerve; Nerve transfer; Thoracodorsal nerve
Hrčak ID:
345840
URI
Publication date:
27.3.2026.
Visits: 249 *