A 26-year-old man with C5-C6 root avulsion has undergone reconstruction of elbow flexion. To restore shoulder abduction and stabilise the glenohumeral joint, the standard donor-to-target combination is:
- A Spinal accessory nerve to the suprascapular nerve ✓
- B Intercostal nerves to the axillary nerve directly
- C Phrenic nerve to the posterior cord
- D Contralateral C7 to the axillary nerve
Correct answer: A. Spinal accessory nerve to the suprascapular nerve
Explanation
Transfer of the spinal accessory nerve to the suprascapular nerve is the workhorse for shoulder function in upper trunk injuries. It reinnervates supraspinatus and infraspinatus, providing abduction initiation and external rotation, and stabilising the humeral head. Intercostal nerves are long and better matched to the musculocutaneous or axillary nerve only when local donors are unavailable, and the phrenic nerve is avoided when pulmonary reserve or diaphragmatic function is compromised.
Reference: Campbell's Operative Orthopaedics, 14th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.