Comparison between donor nerves to motorize the free functional gracilis muscle transfer for elbow flexion: Retrospective study of 38 consecutive cases in traumatic adult brachial plexus injuries
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Citações na Scopus
12
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
PISANI, Marina J.
ALVES, Jairo A.
Citação
MICROSURGERY, v.39, n.5, p.400-404, 2019
Resumo
Purpose Elbow flexion deficit is a frequent problem in traumatic brachial plexus injuries and reestablishment of this function is the primary treatment goal. When management is delayed, or the initial acute approach fails, free functional transfer of the gracilis muscle for elbow flexion is the treatment of choice. In this report, the authors present the results of a comparison study on different donor nerves (spinal accessory and ulnar) in elbow flexion reconstruction with gracilis flap for traumatic adult brachial plexus injuries. Methods Retrospective analysis of patients with both total or partial traumatic brachial plexus injuries was carried out. Of the 38 patients enrolled, 37 were male (97.4%) with a mean age of 28.3 years. The mean follow-up period was 25 months. Postoperative function of the gracilis muscle flap was recorded and patients were divided into two groups according to donor nerve: spinal accessory nerve (SAN) (18 cases), and motor fascicles of the ulnar (ULNAR) (20 cases). Results Twenty-six cases obtained elbow flexion strength M3 or M4 (68.4%): 0 M0 (0.0%), 4 M1 (10.5%), 8 M2 (21.1%), 9 M3 (23.7%) and 17 M4 (44.7%). The mean interval to first recorded M3 muscular strength was 12.4 months. Functional elbow flexion strength (>= M3) had the following distribution: SAN 83.3% (15/18) and ULNAR 55.0% (11/20) (p = .086). Conclusion No statistical difference for final muscle strength was found between donor nerve groups.
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Referências
- Anjos K. C., 2012, THESIS
- AZZE RJ, 1994, MICROSURG, V15, P28, DOI 10.1002/micr.1920150109
- Barrie Kimberly A, 2004, Neurosurg Focus, V16, pE8
- Bengtson KA, 2008, HAND CLIN, V24, P401, DOI 10.1016/j.hcl.2008.04.001
- Bhardwaj P, 2009, J BRACHIAL PLEX PERI, V4, DOI 10.1186/1749-7221-4-3
- Bishop AT, 2005, HAND CLIN, V21, P91, DOI 10.1016/j.hcl.2004.10.005
- Chim H, 2014, J HAND SURG-AM, V39, P1959, DOI 10.1016/j.jhsa.2014.06.020
- Chin K, 2013, J PLAST RECONSTR AES, V66, P144, DOI 10.1016/j.bjps.2012.07.016
- Chuang DCC, 1996, J HAND SURG-AM, V21A, P1071, DOI 10.1016/S0363-5023(96)80318-2
- CHUANG DCC, 1993, J HAND SURG-AM, V18A, P285, DOI 10.1016/0363-5023(93)90363-8
- Colbert SH, 2008, HAND CLIN, V24, P341, DOI 10.1016/j.hcl.2008.07.001
- Coulet B, 2011, ORTHOP TRAUMATOL-SUR, V97, P479, DOI [10.1016/j.otsr.2011.03.022, 10.1016/j.otsr.2011.07.012]
- Dyck PJ, 2005, J PERIPHER NERV SYST, V10, P158, DOI 10.1111/j.1085-9489.2005.0010206.x
- Flores LP, 2006, ARQ NEURO-PSIQUIAT, V64, P88, DOI 10.1590/S0004-282X2006000100018
- Giuffre JL, 2012, J RECONSTR MICROSURG, V28, P349, DOI 10.1055/s-0032-1313767
- Gousheh J, 2010, J HAND SURG-EUR VOL, V35E, P16, DOI 10.1177/1753193409348182
- Ikuta Y, 1979, Ann Acad Med Singapore, V8, P454
- Kay S, 2010, J PLAST RECONSTR AES, V63, P1142, DOI 10.1016/j.bjps.2009.05.021
- Kimura Luiz Koiti, 2011, Rev. bras. ortop., V46, P534, DOI [10.1590/S0102-36162011000500009, 10.1016/S2255-4971(15)30408-0]
- KRAKAUER JD, 1994, J HAND SURG-AM, V19A, P829, DOI 10.1016/0363-5023(94)90196-1
- Lin SH, 2004, J RECONSTR MICROSURG, V20, P227
- MANKTELOW RT, 1989, ANN PLAS SURG, V22, P275, DOI 10.1097/00000637-198904000-00001
- Medical Research Council, 1981, 45 MRC
- NARAKAS AO, 1985, INT ORTHOP, V9, P29, DOI 10.1007/BF00267034
- Oberlin C, 2009, CHIR MAIN, V28, P1, DOI 10.1016/j.main.2008.11.010
- Rocha J. R., 2004, REV INTO, V2, P11
- Stockinger T, 2008, J HAND SURG-AM, V33A, P1100, DOI 10.1016/j.jhsa.2008.03.010
- Sungpet A, 2003, ANZ J SURG, V73, P133, DOI 10.1046/j.1445-2197.2003.02654.x
- Teboul F, 2004, J BONE JOINT SURG AM, V86A, P1485, DOI 10.2106/00004623-200407000-00018