Patient-reported Outcomes Following Intercostal Nerve Transfer to Musculocutaneous Nerve at a Median Follow-up of 3.5 Years.

Background: The objective of this study was to evaluate the outcomes of neurotization of the musculocutaneous nerve (MCN) using intercostal nerves (ICNs) to restore elbow flexion in patients with complete brachial plexus paralysis (CBPP). We assessed quality of life through patient-reported outcome measures and examined the impact on respiratory function. Methods: This retrospective study included 17 patients with CBPP who underwent ICN transfer to the MCN. The median follow-up was 3.5 years. Outcome measures included elbow flexion strength (British Medical Research Council grading), quality of life (Quick Disabilities of the Arm, Shoulder, and Hand and Short Form-36), and respiratory function. Patient-reported outcome measures were evaluated using the Overall Subjective Self-Assessment score. Results: The median age at the time of injury was 24 years (interquartile range: 19-28 y). Seven (41%) patients achieved elbow flexion strength of M3 or higher. The median active elbow flexion was 120 degrees in patients with strength of M3 or higher, compared with 25 degrees in those with strength less than M3 ( Conclusions: Neurotization of the MCN with ICN in patients with CBPP can restore functional elbow flexion and improve quality of life without adversely affecting respiratory function. Although improvements remain modest, the restored elbow flexion significantly enhances upper limb function, supporting its continued use as a viable treatment option in the management of CBPP.