PMC4789804_01
EMG results table and summary for right upper limb.
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F1
Neurophysiological evaluation confirmed denervation of the C5,6 muscles, as well as loss of the SAN, long thoracic nerve, and dorsal scapular nerve (Figure 1).
Schematic representation of the right upper brachial plexus represented in blue, with the suprascapular nerve (SSN) entering the suprascapular notch. The thoracodorsal nerve (TDN), on the posterolateral border of the axilla, is represented in green. Point X represents the proximal neurotomy on the recipient SSN. Point Y represents the distal neurotomies on the donor thoracodorsal nerves (TDN).
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F2
With the patient in a supine position and through a right supraclavicular incision, the SSN was neurolysed from its upper trunk origin to within 2 cm of the suprascapular notch (Figure 2).
Neurotomy was performed proximal on the SSN, close to its origin from the upper trunk of the brachial plexus, and the nerve tunneled under the right clavicle. The terminal branches of the TDN were divided as distal as possible and tunneled under pectoralis major to lie in the deltopectoral groove.
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F3
Neurotomies were performed as distal as possible on the four terminal nerve branches, which were then tunneled deep to pectoralis major muscle toward the recipient nerve (Figure 3).