Enrico Martin

269 Morbidity and function loss after resection of MPNST Table 5 Possibilities for reconstruction Location Motor deficit Reconstruction Value a Sensory deficit Value a Upper extremity Brachial plexus 2 Arm, shoulder, and hand function TT, NT, NG, FFMT ++ Arm, shoulder, and hand + Musculocutaneous nerve Biceps function NT, NG, FFMT ++ Lateral lower arm +/- Axillary nerve Shoulder abduction / stabilization NT, NG, TT, FFMT + Lateral upper arm +/- Median nerve Proximal Wrist and finger flexion TT, NT, NG, FFMT ++ Hand palm, dig. I-IV + Distal Thumb function TT, NG, NT, FFMT ++ Hand palm, dig. I-IV ++ Radial nerve Proximal Triceps function, wrist and finger extension TT, NT, NG, FFMT ++ Posterior arm and radiodorsal hand, dig. I + Distal NA NA NA Radiodorsal hand, dig. I + Ulnar nerve Hand function TT, NT, NG, FFMT ++ Ulnar side arm and hand, dig. IV-V ++ Lower extremity Lumbosacral plexus 3 Gluteal, leg, ankle, and foot function NG, NT, TT, FFMT + Complete leg, buttocks, foot +/- Sciatic nerve Proximal Biceps femoris, ankle, and foot function NG, TT, FFMT +/- Dorsal proximal leg, laterodorsal distal leg, plantar and dorsal foot +/- Distal Ankle and foot function NG +/- Laterodorsal distal leg, plantar and dorsal foot + Femoral nerve Proximal Quadriceps and iliopsoas function NT, TT, NG, FFMT ++ Ventrolateral proximal leg, medial distal leg +/- Distal Quadriceps function NT, TT, NG, FFMT ++ Medial distal leg +/- Obturator nerve Adductors TT, NG, FFMT +/- Medial proximal leg +/- Peroneal nerve Foot and toe extension TT, NT, NG, FFMT ++ Lateral lower leg, dorsum foot +/- Tibial nerve Foot and toe flexion NG, TT, NT, FFMT + Dorsal lower leg, plantar foot ++ Head and neck Facial nerve Facial expression FFMT, TG, NG, NT ++ No NA Spinal accessory nerve Trapezius function NG, NT + No NA Hypoglossal nerve Tongue function NG + No NA a Value of reconstructing the defect based on functional gain and anticipated effect. +/-: uncertain value, +: possibly worthwhile, ++: worthwhile; 2In case of complete brachial plexus palsy, tendon transfers impossible; 3In case of complete lumbosacral plexus palsy, no reconstructions possible dig.: digit, FFMT: free functioning muscle transfers, N: number of patients, NA: not applicable, NG: nerve grafting, NT: nerve transfers, TG: tendon grafts, TT: tendon transfers 11