A Prospective Study Comparing Single and Double Fascicular Transfer to Restore Elbow Flexion After Brachial Plexus Injury

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMARTINS, Roberto Sergio
dc.contributor.authorSIQUEIRA, Mario Gilberto
dc.contributor.authorHEISE, Carlos Otto
dc.contributor.authorFORONI, Luciano
dc.contributor.authorTEIXEIRA, Manoel Jacobsen
dc.date.accessioned2013-09-23T16:41:22Z
dc.date.available2013-09-23T16:41:22Z
dc.date.issued2013
dc.description.abstractBACKGROUND: The recovery of elbow flexion in upper brachial plexus injury can be achieved by the reinnervation of the biceps muscle (single reinnervation), but concomitant restoration of brachialis and biceps function (double reinnervation) has been recommended to improve elbow flexion strength. OBJECTIVE: To prospectively compare morbidity and outcomes of single or double muscle reinnervation in restoring elbow flexion following incomplete injury to the brachial plexus. METHODS: Forty consecutive patients were prospectively submitted to single or double muscle reinnervation. Elbow flexion strength was evaluated with a push-and-pull dynamometer 12 months after surgery. Hand morbidity related to the procedures was evaluated by the Semmes-Weinstein monofilaments test, quantification of static 2-point discrimination, and measurements of handgrip and lateral pinch strength in serial evaluations up to the final follow-up. RESULTS: Similar results for the strength of elbow flexion were observed in both groups. A worsening of sensibility, measured by using Semmes-Weinstein monofilaments, was identified in 8 patients, all of whom showed recovery during follow-up. No worsening of 2-point discrimination was observed. A decrease in handgrip and lateral pinch strength was identified in 8 and 9 patients, respectively, which improved during follow-up. There was no difference between the groups in the incidence of hand motor morbidity parameters. CONCLUSION: The strength of elbow flexion did not differ significantly between the groups treated with single or double muscle reinnervation. Deterioration of handgrip, lateral pinch strength, and sensibility measured by using Semmes-Weinstein monofilaments, was temporary, resulting in low morbidity for both techniques.
dc.description.indexMEDLINE
dc.description.sponsorshipNational Council for Scientific and Technological Development (CNPq)
dc.identifier.citationNEUROSURGERY, v.72, n.5, p.709-714, 2013
dc.identifier.doi10.1227/NEU.0b013e318285c3f6
dc.identifier.issn0148-396X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/1999
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.relation.ispartofNeurosurgery
dc.rightsrestrictedAccess
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINS
dc.subjectBrachial plexus
dc.subjectBrachial plexus repair
dc.subjectNerve injury
dc.subjectUpper brachial plexus neuropathy
dc.subject.othernerve transfer
dc.subject.otherbiceps muscle
dc.subject.otherulnar nerve
dc.subject.otheravulsion injury
dc.subject.otherschwann-cell
dc.subject.otherpalsy
dc.subject.otherc5
dc.subject.otherreconstruction
dc.subject.otherfascicles
dc.subject.otherextension
dc.subject.wosClinical Neurology
dc.subject.wosSurgery
dc.titleA Prospective Study Comparing Single and Double Fascicular Transfer to Restore Elbow Flexion After Brachial Plexus Injury
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus52
hcfmusp.contributor.author-fmusphcROBERTO SERGIO MARTINS
hcfmusp.contributor.author-fmusphcMARIO GILBERTO SIQUEIRA
hcfmusp.contributor.author-fmusphcCARLOS OTTO HEISE
hcfmusp.contributor.author-fmusphcLUCIANO HENRIQUE LOPES FORONI
hcfmusp.contributor.author-fmusphcMANOEL JACOBSEN TEIXEIRA
hcfmusp.description.beginpage709
hcfmusp.description.endpage714
hcfmusp.description.issue5
hcfmusp.description.volume72
hcfmusp.origemWOS
hcfmusp.origem.pubmed23313985
hcfmusp.origem.scopus2-s2.0-84876717378
hcfmusp.origem.wosWOS:000317915100008
hcfmusp.publisher.cityPHILADELPHIA
hcfmusp.publisher.countryUSA
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hcfmusp.remissive.sponsorshipCNPq
hcfmusp.scopus.lastupdate2024-05-17
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