Ahead of Print: Spinal Nerve Origins of Radial Nerve Muscular Branches

Background: In injuries of the lower brachial plexus, finger flexion can be restored by nerve or tendon transfer. However, there is no technique that can guarantee good recovery of finger and thumb extension.

Objective: To determine the spinal nerve origins of the muscular branches of the radial nerve and identify potential intraplexus donor nerves for neurotization of the posterior interosseous nerve in patients with lower brachial plexus injuries.

Methods: An intraoperative electrophysiological study was carried out during 16 contralateral C7 nerve transfers. The CMAP (compound muscle action potential) of each muscle innervated by the radial nerve was recorded while the C5-T1 nerves were individually stimulated.