A. Hora1, M. Makeľ2,3, A. Whitley4–6, D. Kachlík4,6, R. Kaiser4,6–8
1 Department of Anatomy, Third Faculty of Medicine, Charles University, and University Hospital Královské Vinohrady, Prague, Czech Republic 2 Department of Plastic and Aesthetic Surgery, St. Anne‘s University Hospital Brno, Czech Republic 3 Department of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic 4 Department of Anatomy, Second Faculty of Medicine, Charles University, Prague, Czech Republic 5 Department of General Surgery, Third Faculty of Medicine, Charles University, and University Hospital Královské Vinohrady, Prague, Czech Republic 6 Center for Endoscopic, Surgical and Clinical Anatomy (CESKA), Second Faculty of Medicine, Charles University, Prague, Czech Republic 7 Department of Spinal Surgery, Oxford University Hospitals NHS Trust, Oxford, United Kingdom 8
Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University, and Military University Hospital Prague, Czech Republic
Summary
Introduction: Isolated musculocutaneous nerve injuries occur rarely due to their anatomical location. We present our patient with a musculocutaneous nerve injury in a motorcyclist. Case: The patient was initially treated for a motorcycle accident. Further examination of the patient revealed impaired elbow flexion and numbness of the lateral forearm. Electromyography confirmed impaired function of the musculocutaneous nerve. After 3 months, the patient‘s condition did not show any improvement, neither electromyography confirmed recovery of the nerve activity, so surgical treatment was planned. In the surgical revision, neuroma-in-continuity was discovered and resected. The resulting nerve defect was 6 cm long. We provided nerve grafting using sural nerve from the right lower limb. After surgery, the patient began physical therapy and electrical stimulation. Two years later, the patient reached complete recovery of muscle strength. Conclusion: Due to the lack of improvement after a 3-month period, we proceeded with a surgical revision, which demonstrated a complete lesion of the nerve that could not heal spontaneously. Therefore, we opted for the nerve graft method and the patient regained full function of elbow flexors.
Key words
isolated musculocutaneous nerve injury – motorcycle accident – neurotmesis – isolated nerve injury – nerve transfer
Hora A, Makeľ M, Whitley A et al. Isolated musculocutaneous nerve injury in a motorcyclist – a case report. Acta Chir Plast 2024; 66 (2): 86–89.