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Erschienen in: International Orthopaedics 3/2021

18.11.2020 | Original Paper

Free gracilis muscle transfer with ulnar nerve neurotization for elbow flexion restoration

verfasst von: Marcelo R. De Rezende, Bruno A. Veronesi, Renata G. Paulos, Alvaro B. Cho, Samuel Ribak, Rames M. Junior

Erschienen in: International Orthopaedics | Ausgabe 3/2021

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Abstract

Purpose

In upper and chronic brachial plexus injuries for which neurological surgery is not a good treatment option, one possibility for gaining elbow flexion is free functional muscle transfer. The primary aim of our study was to evaluate the elbow flexion gain achieved by free gracilis muscle transfer with partial ulnar nerve neurotization.

Methods

This surgery was performed in 21 patients with upper and chronic (> 12 months) brachial plexus injuries. The level of injury, patient age, the time between trauma and surgery, the affected side, and the aetiology of the lesion were recorded. The primary outcome evaluated was elbow flexion muscle strength, which was measured using the British Medical Research Council (BMRC) scale, in patients with a minimum follow-up period of 12 months. The criterion used to classify elbow flexion as good was a grade of M4 or higher.

Results

An M4 elbow flexion strength gain was observed in 61.9% of the patients. A gain of M2 or higher was observed in 95.2% of the patients. The mean range of active motion was 77° (range 10 minimum–110 maximum).

Conclusion

In patients with upper and chronic brachial plexus injuries, free gracilis muscle transfer with ulnar nerve neurotization yields a satisfactory gain in elbow flexion strength and is therefore a good treatment option.
Literatur
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Metadaten
Titel
Free gracilis muscle transfer with ulnar nerve neurotization for elbow flexion restoration
verfasst von
Marcelo R. De Rezende
Bruno A. Veronesi
Renata G. Paulos
Alvaro B. Cho
Samuel Ribak
Rames M. Junior
Publikationsdatum
18.11.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 3/2021
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04873-7

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