Use of intercostal nerves for different target neurotization in brachial plexus reconstruction

Figure 1 A curved incision starts at the anterior axillary line at the level of the upper chest and extents caudally towards the midline of the abdomen at the level of the umbilicus, depending on the number of intercostals nerves to be harvested.

Figure 2 The motor branch is identified on top of the innermost intercostal muscle and dissected from the costochondral junction anteriorly to the posterior axillary line posteriorly. The intercostal nerves are passed to the axilla through a subcutaneous tunnel so they can be sutured to the recipient nerve. Note the intercostal nerve 5 (*) and the intercostal nerve 6 (**) after their dissection and mobilization.