A technique for maximizing biceps recovery in brachial plexus reconstruction

In 21 cadaver dissections the intramuscular anatomy of the musculocutaneous nerve and the relative relationship of the motor and sensory components of this nerve were evaluated. Nearly one half of the fibers entering the musculocutaneous nerve terminate in cutaneous receptors. We report five cases in which biceps reinnervation was performed by a surgical technique that minimizes the period of denervation by using motor nerves (medial pectoral nerves) very close to the biceps muscle. This technique also redirects the cutaneous portion (lateral anterbrachial cutaneous nerve) of the musculocutaneous nerve into the biceps muscle to ensure that the motor fibers are not directed toward cutaneous receptors.