Neurotización del nervio musculocutáneo con los nervios intercostales asistidos con videotoracoscopia. Caso clínico en paciente con parálisis del plexo braquial

Abstract

In total brachial plexus preganglionic lesions (C5-C6-C7-C8 and T1) different extraplexual neurotizations are indicated for partial motor function restitution. Mostly for the flexion of the elbow .^(1,3,4). Neurotization with intercostal nerves (ICN) to musculocutaneous nerve has been known and accepted during many years with different results ^(2,3,4,5). The customary technique as described by various authors is carried out by means of a large submammary incision to harvest three or four intercostal nerves (Figure 1). Then are connected by direct suture or grafts to the musculocutaneous nerve or its motor branches. ^{(6 , 7)}. Based on a previous study by the author on the possibility of performing the dissection of the intercostal nerves by videothoracoscopy, ⁽⁷⁾ we present a clinical case of a 29-year-old patient with a complete brachial plexus injury in which we performed this technique and its result at 2 years.