Free gracilis muscle transfer with ulnar nerve neurotization for elbow flexion restoration
Carregando...
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Citação
INTERNATIONAL ORTHOPAEDICS, v.45, n.3, p.689-696, 2021
Resumo
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 degrees (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.
Palavras-chave
Nerve transfer, Brachial plexus, Ulnar nerve, Flap
Referências
- Bertelli JA, 2004, J HAND SURG-AM, V29A, P131, DOI 10.1016/j.jhsa.2003.10.013
- Chim H, 2014, J HAND SURG-AM, V39, P1959, DOI 10.1016/j.jhsa.2014.06.020
- Cho AB, 2019, MICROSURG, V39, P400, DOI 10.1002/micr.30426
- Chuang DCC, 1996, J HAND SURG-AM, V21A, P1071, DOI 10.1016/S0363-5023(96)80318-2
- Coulet B, 2010, J HAND SURG-AM, V35A, P1297, DOI 10.1016/j.jhsa.2010.04.025
- de Carvalho HB, 2016, DRUG ALCOHOL DEPEN, V162, P199, DOI 10.1016/j.drugalcdep.2016.03.007
- de Rezende MR, 2013, CLINICS, V68, P411, DOI 10.6061/clinics/2013(03)R02
- Giuffre JL, 2010, J HAND SURG-AM, V35A, P678, DOI 10.1016/j.jhsa.2010.01.021
- Hattori Y, 2002, J HAND SURG-AM, V27A, P534, DOI 10.1053/jhsu.2002.32962
- Ikuta Y, 1979, Ann Acad Med Singap, V8, P454
- Kakinoki R, 2010, J BRACHIAL PLEX PERI, V5, DOI 10.1186/1749-7221-5-4
- Kay S, 2010, J PLAST RECONSTR AES, V63, P1142, DOI 10.1016/j.bjps.2009.05.021
- Macchi V, 2008, CLIN ANAT, V21, P696, DOI 10.1002/ca.20685
- Madura T, 2018, J HAND SURG-EUR VOL, V43, P596, DOI 10.1177/1753193418762950
- Maldonado AA, 2017, PLAST RECONSTR SURG, V139, P128, DOI 10.1097/PRS.0000000000002864
- NAGANO A, 1992, J HAND SURG-AM, V17A, P815, DOI 10.1016/0363-5023(92)90450-4
- NARAKAS AO, 1985, INT ORTHOP, V9, P29, DOI 10.1007/BF00267034
- NARAKAS AO, 1988, CLIN ORTHOP RELAT R, P43
- Nath Rahul K, 2017, Eplasty, V17, pe34
- Nicoson MC, 2017, MICROSURG, V37, P377, DOI 10.1002/micr.30120
- OBERLIN C, 1994, J HAND SURG-AM, V19A, P232, DOI 10.1016/0363-5023(94)90011-6
- Potter SM, 2017, J HAND SURG-EUR VOL, V42, P693, DOI 10.1177/1753193417702029
- Songcharoen P, 2005, HAND CLIN, V21, P83, DOI 10.1016/j.hcl.2004.10.002
- Sungpet A, 2003, ANZ J SURG, V73, P133, DOI 10.1046/j.1445-2197.2003.02654.x
- Waikakul S, 1999, J HAND SURG-AM, V24A, P571
- Yang Y, 2016, SCI REP-UK, V6, DOI 10.1038/srep22479