Brachialis Muscle Transfer to Reconstruct Finger Flexion or Wrist Extension in Brachial Plexus Palsy

2006 ◽  
Vol 31 (2) ◽  
pp. 190-196 ◽  
Author(s):  
Jayme Augusto Bertelli ◽  
Marcos Flávio Ghizoni
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Wrist Extension ◽  
Finger Flexion ◽  
Brachialis Muscle

scholarly journals Outcomes of Brachialis Muscle Transfer to Restore Finger Flexion in Traumatic Lower Trunk Brachial Plexus Palsy

2017 ◽  
Vol 42 (9) ◽  
pp. S33-S34
Author(s):  
Brent R. DeGeorge ◽  
Hillary Ann Becker ◽  
John Faryna ◽  
Robert Spinner ◽  
Allen T. Bishop ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Lower Trunk ◽  
Finger Flexion ◽  
Brachialis Muscle

Brachialis Muscle Transfer to the Forearm Muscles in Obstetric Brachial Plexus Palsy

2006 ◽  
Vol 31 (3) ◽  
pp. 261-265 ◽  
Author(s):  
J. A. BERTELLI
Keyword(s):  
Brachial Plexus ◽  
Hand Function ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Wrist Extension ◽  
Active Motion ◽  
Obstetric Brachial Plexus Palsy ◽  
Brachialis Muscle ◽  
Obstetric Brachial Plexus ◽  
Extensor Carpi Radialis

Tendon transfers are frequently needed to improve hand function in obstetric brachial plexus injuries. The reconstruction cannot always be achieved using local donor transfers in the forearm as these are not always available. In such cases, we propose the use of the brachialis muscle as a useful donor for transfer. Five adolescents with obstetric brachial plexus palsy were operated on to reconstruct wrist extension and/or pronation using the brachialis muscle transfer to the pronator teres ( n = 1) extensor carpi radialis brevis ( n = 1) and extensor carpi radialis longus ( n = 3). Twelve months after surgery, average active motion recovery was 20° for wrist extension and 14° for pronation. Active and passive range of motion was similar.

scholarly journals Gracilis free muscle transfer for restoration of function after complete brachial plexus avulsion

2004 ◽  
Vol 16 (5) ◽  
pp. 1-9 ◽  
Author(s):  
Kimberly A. Barrie ◽  
Scott P. Steinmann ◽  
Alexander Y. Shin ◽  
Robert J. Spinner ◽  
Allen T. Bishop
Keyword(s):  
Brachial Plexus ◽  
Upper Extremity ◽  
Elbow Flexion ◽  
Muscle Transfer ◽  
Muscle Flaps ◽  
Wrist Extension ◽  
Finger Flexion ◽  
Vascular Insufficiency ◽  
Flexion Strength

Object The authors report the functional outcomes after functioning free muscle transfer (FFMT) for restoration of the upper-extremity movement after brachial plexus injury (BPI). Methods The authors conducted a retrospective review of 36 gracilis FFMT procedures performed in 27 patients with BPI between 1990 and 2000. Eighteen patients underwent a single gracilis FFMT procedure for restoration of either elbow flexion (17 cases) or finger flexion (one case). Nine patients underwent a double free muscle transfer for simultaneous restoration of elbow flexion and wrist extension (first muscle) and finger flexion (second muscle), combined with direct triceps neurotization. The results obtained in 29 cases of FFMT in which the follow-up period was 1 year are reported. Neurotization of the donor muscle was performed using the musculocutaneous nerve (one case), spinal accessory nerve (12 cases), or multiple intercostal motor nerves (16 cases). Two second-stage muscle flaps failed secondary to vascular insufficiency. Mean electromyography-measured reinnervation time was 5 months. At a minimum follow-up period of 1 year, five muscles achieved less than or equal to Grade M2, eight Grade M3, four Grade M4, and 12 Grade M5. Transfer for combined elbow flexion and wrist extension compared with elbow flexion alone lowered the overall results for elbow flexion strength. Seventy-nine percent of the FFMTs for elbow flexion alone (single transfer) and 63% of similarly innervated muscles transferred for combined motion achieved at least Grade M4 elbow flexion strength. Conclusions Functioning free muscle transfer is a viable reconstructive option for restoration of upper-extremity function in the setting of severe BPI. It is possible to achieve good to excellent outcomes in terms of muscle grades with the simultaneous reconstruction of two functions by one FFMT, making restoration of basic hand function possible. More reliable results are obtained when a single FFMT is performed for a single function.

Transfer of the supinator muscle to the extensor pollicis brevis for thumb extension reconstruction in C7-T1 brachial plexus palsy

2009 ◽  
Vol 35 (1) ◽  
pp. 29-31 ◽  
Author(s):  
J. A. Bertelli ◽  
M. F. Ghizoni ◽  
C. P. Tacca
Keyword(s):  
Brachial Plexus ◽  
Motor Nerve ◽  
Flexor Digitorum Profundus ◽  
Brachial Plexus Palsy ◽  
Extensor Pollicis Brevis ◽  
Finger Flexion ◽  
Supinator Muscle ◽  
Brachialis Muscle ◽  
Finger Motion ◽  
Flexor Digitorum

With C7-T1 brachial plexus injuries, finger motion is absent while shoulder, elbow and wrist function are largely preserved. Previously, we have reconstructed finger flexion by transferring the brachialis muscle to the flexor digitorum profundus and flexor pollicis longus; and we have restored extension of thumb and finger by transferring the motor nerve to the supinator to the posterior interosseous nerve, which is only feasible in fresh injuries. We describe the transfer of the supinator muscle to the extensor pollicis brevis to reanimate thumb extension in patients with long standing C7-T1 brachial plexus palsy.

scholarly journals “ALL IN ONE OR (W)HOLE IN ONE REPAIR” for Adult Total Brachial Plexus Palsy

2021 ◽  
Author(s):  
V. Purushothaman ◽  
K. Vinoth Kumar ◽  
Sabari Girish Ambat ◽  
R. Venkataswami
Keyword(s):  
Brachial Plexus ◽  
Hand Function ◽  
The Body ◽  
Salvage Procedure ◽  
Brachial Plexus Palsy ◽  
Nerve Reconstruction ◽  
Muscle Transfer ◽  
Young Males ◽  
Elbow Function ◽  
Better Than

Abstract Background Total brachial plexus palsy (TBPP) accounts for nearly 50% of all brachial plexus injuries. Since achieving a good functional hand was almost impossible, the aim was settled to get a good shoulder and elbow function. It was Gu, who popularized the concept of utilizing contralateral C7 (CC7) with vascularized ulnar nerve graft (VUNG) to get some hand function. We have modified it to suit our patients by conducting it as a single-stage procedure, thereby trying to get a functional upper limb. Methods From 2009 to 2014, we had 20 TBPP patients. We feel nerve reconstruction is always better than any other salvage procedure, including free muscle transfer. We modified Gu's concept and present our concept of total nerve reconstruction as “ALL IN ONE OR (W)HOLE IN ONE REPAIR.” Results All patients able to move their reconstructed limbs independently or with the help of contralateral limbs. Three patients developed hook grip and one patient was able to incorporate limbs to do bimanual jobs. One important observation is that all the reconstructed limbs regain the bulk, and to a certain extent, the attitude and appearance looks normal, as patients no longer hide it or hang it in a sling. Conclusion Adult brachial plexus injury itself is a devastating injury affecting young males. By doing this procedure, the affected limb is not dissociated from the rest of the body and rehabilitation can be aimed to get a supportive limb.

Bilateral Elbow Flexion Reconstruction with Functioning Free Muscle Transfer for Obstetric Brachial Plexus Palsy

2002 ◽  
Vol 27 (5) ◽  
pp. 484-486 ◽  
Author(s):  
A. S. BALIARSING ◽  
K. DOI ◽  
Y. HATTORI
Keyword(s):  
Brachial Plexus ◽  
Elbow Flexion ◽  
Gracilis Muscle ◽  
Brachial Plexus Palsy ◽  
Muscle Transfer ◽  
Nerve Roots ◽  
Obstetric Brachial Plexus Palsy ◽  
Shoulder Joints ◽  
Muscle Transfers ◽  
Obstetric Brachial Plexus

A child suffered a bilateral obstetric brachial plexus palsy involving the C5 and C6 nerve roots. Abduction of the shoulder joints had recovered by 1 year, but elbow flexion did not recover on either side. Free gracilis muscle transfers were performed on both sides, at an interval of 6 months, to achieve elbow flexion. The spinal accessory nerve was used as the donor nerve.

Outcomes of Muscle Brachialis Transfer to Restore Finger Flexion in Brachial Plexus Palsy

2017 ◽  
Vol 140 (2) ◽  
pp. 307e-317e ◽  
Author(s):  
Brent R. DeGeorge ◽  
Hillary A. Becker ◽  
John H. Faryna ◽  
Robert J. Spinner ◽  
Allen T. Bishop ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Palsy ◽  
Finger Flexion

Tendon Transfer to Reconstruct Wrist Extension in Children with Obstetric Brachial Plexus palsy

2003 ◽  
Vol 28 (2) ◽  
pp. 153-157 ◽  
Author(s):  
M. M. Al-QATTAN
Keyword(s):  
Brachial Plexus ◽  
Tendon Transfer ◽  
Brachial Plexus Palsy ◽  
Wrist Extension ◽  
Obstetric Brachial Plexus Palsy ◽  
System A ◽  
Flexor Carpi Ulnaris ◽  
Obstetric Brachial Plexus ◽  
Wrist Drop ◽  
Extensor Carpi Radialis

This study reports on 20 children with obstetric brachial plexus palsy who underwent a tendon transfer to reconstruct wrist extension. The mean age at the time of tendon transfer was 8 years. There were seven patients with Erb’s palsy and the remaining 13 had total palsy. The flexor carpi ulnaris was utilized 15 times and the flexor carpi radialis five times. The transferred tendon was sutured to the tendon of the extensor carpi radialis brevis. The result of the transfer was assessed according to a modified Medical Research Council (MRC) muscle grading system. A good result was obtained in 18 patients (modified MRC grade of 4) and a fair result (modified MRC grade of 3) in two. The choice of tendon transfer to reconstruct the wrist drop deformity in various conditions including adult traumatic brachial plexus injuries is discussed.

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