One-Stage Nerve Repair for Post-Ganglionic Brachial Plexus Injury by Using Ipsilateral Ruptured Ulnar Nerve as a Donor for Axillary Artery Rupture with Open Wound.

Abstract

Open axillary arterial injury is life-threatening, and upper-extremity reperfusion must be performed within approximately 6 h. We present the case of a patient who underwent reperfusion of the upper limb and nerve reconstruction of the post-ganglionic brachial plexus injury in one stage while maintaining stable vital signs. The injury was an avulsion with no fracture. Nerve grafting was necessary to reconstruct the nerves without tension. Although the sural nerve is commonly used, we decided to sacrifice the ipsilateral ruptured ulnar nerve because it was less likely to recover over a long reinnervation distance. Nine months postoperatively, the patient was able to flex the elbow and rotate the forearm, although finger function was poor. Nevertheless, the patient could use the hand to assist her in performing daily activities and return to the previous workplace as a clerk. J. Med. Invest. 71 : 332-334, August, 2024.