Direct cord implantation in brachial plexus avulsions: revised technique using a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy

Table 1 The demographic data of the patients, lesion types, operative procedures, preoperative cocontractions and deformities and the pre- and postoperative evaluation scores

Pt	Age (yrs) sex	Type of injury	Time of surgery after injury (mths)	Procedure	Nerve grafts	Associated injuries	Deformities	Shoulder score Narakas (N), Gilbert (G)	Elbow score Waikakul (W). Gilbert (G)	Hand score Raimondi (R)
1	27 M	C5,6,7,8T1 avulsion lt. brachial plexus; retraction of the brachial plexus to the deltopectoral groove	8	Direct cord implantation	Both surals	Retroclaclavicular CSF sac; neglected rupture of subclavian artery; delayed union of fracture of the lt. humerus	Volkmann's ischaemic contracture	Ngood	Wgood	R0
2	40 M	C5,6,7,8T1 avulsion rt. brachial plexus; retraction of the brachial plexus to the deltopectoral groove	12	Direct cord implantation	Both surals	grafted subclavian artery	-	Ngood	Wgood	R0
3	45 M	C5,6 rupture C7,8T1 avulsion rt. brachial plexus; retraction of the brachial plexus to the outer border of scalenus anterior muscle	8	C5,6 grafting to superior trunk, C7,8T1: direct cord implantation	Medial cutaneous nerve of forearm, superficial radial nerve, supraclavicular nerves	-	-	Nexcellent	Wexcellent	R3
4	30 M	C5,6 rupture C7,8T1 avulsion lt. brachial plexus; retraction of the brachial plexus to the clavicle	8	C5,6 grafting to superior trunk, C7,8T1: direct cord implantation	Medial cutaneous nerve of forearm, superficial radial nerve, supraclavicular nerves	-	-	Nexcellent	Wexcellent	R3
5	1 M	C5,6,7,8T1 avulsion rt. brachial plexus; retraction of the brachial plexus to the clavicle; obstetric palsy	12	Direct cord implantation	Medial cutaneous nerve of forearm, superficial radial nerve			Ngood, G3	Ggood	R4