A patient with complete C5–C6 avulsion brachial plexus injury undergoes intercostal nerve transfer to the musculocutaneous nerve to restore elbow flexion. The earliest clinical evidence of reinnervation should appear approximately:

• A 2–4 weeks postoperatively
• B 10–18 months postoperatively
• C 3–6 months postoperatively ✓
• D Only after 3 years, if at all

Explanation

After nerve transfer, axons regenerate at approximately 1 mm/day (or about 1 inch/month). The distance from the anastomosis site (typically near the clavicle) to the biceps muscle in an adult is roughly 10–15 cm, meaning clinical contraction should be expected in 3–6 months. Patients are trained to cough or breathe to synchronise intercostal nerve firing with elbow flexion preoperatively. Outcome plateaus at 18–24 months.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.