In an adult patient with a C5-C6 postganglionic brachial plexus injury and a functional hand, which nerve transfer is used to restore shoulder abduction by reinnervating the supraspinatus and infraspinatus?

• A Spinal accessory nerve to the suprascapular nerve ✓
• B Radial nerve branch to triceps transferred to the axillary nerve
• C Ulnar nerve fascicle to the nerve to biceps
• D Phrenic nerve to the posterior cord

Explanation

The spinal accessory to suprascapular nerve transfer is the standard workhorse for restoring shoulder abduction and external rotation in upper trunk injuries, because the suprascapular nerve supplies supraspinatus and infraspinatus, the two most important initiators of abduction. The triceps branch to axillary nerve transfer is an alternative but is not the classic first choice. The ulnar fascicle transfer is the Oberlin procedure, which targets elbow flexion, not shoulder function.

Reference: Campbell's Operative Orthopaedics, 14th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.