Musculocutaneous Nerve Palsy

• 8.2% of pts undergoing open anterior reconstructions for GH instability will have a neurologic deficit. 78% of these will have complete resolution of the deficit. (JSES 1999;8:266)
• Neuroligic injury/brachial plexus palsy has been associated with scalene block anesthesia (Weber, JBJS 2002;84A:775)
• Signs of injured peripheral nerve recovery(radial nerve) can be delayed longer than 6 months.  EMG/NCV findings parallel clinical findings and show signs of recovery no more than a month before clinically evident.  Complete nerve recovery can take 2 years or more. (Ring, J Hand Surg 2004;29A:144)
• Musculocutaneous nerve palsies can be treated by intercostal to musculocutaneous nerve transfers.  90% achieve >/= M3 biceps strength, 70% achieve >M4 strength.  Nerve transfers are best done within 9 months of injury.  (Merrell, J Hand Surg 2001;26A;303)