Outcome of free gracilis muscle transfer for the restoration of elbow flexion in traumatic brachial plexus palsy

被引:7
作者
Armangil, Mehmet [1 ]
Unsal, Seyyid Serif [2 ]
Yildirim, Tugrul [3 ]
Bezirgan, Ugur [4 ]
Keremov, Anar [1 ]
Adiyaman, Sinan [1 ]
Bilgin, Sirri Sinan [1 ]
机构
[1] Ankara Univ, Dept Orthoped & Traumatol, Fac Med, Ankara, Turkey
[2] Kanuni Training & Res Hosp, Dept Hand Surg, Trabzon, Turkey
[3] Hand & Microsurgery Orthoped & Traumatol Hosp, Dept Orthoped & Traumatol, Izmir, Turkey
[4] Ankara City Hosp, Dept Hand Surg, Ankara, Turkey
关键词
Brachial plexus paralysis; elbow flexion; free muscle transfer; neurotization; QUALITY-OF-LIFE; RECONSTRUCTION; NEUROTIZATION; INJURIES; TRANSPLANTATION; PARALYSIS; AVULSION;
D O I
10.52312/jdrs.2021.225
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objectives: The aim of this study was to evaluate the functional outcomes of patients with free gracilis muscle transfer (FGMT) for the restoration of elbow flexion. Patients and methods: Between January 2012 and January 2019, a total of 16 patients (13 males, 3 females; mean age: 27.3 +/- 11.7 years; range: 18 to 53 years) who underwent FGMF to achieve elbow flexion after traumatic brachial plexus palsy (TBPP) were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, etiology, affected side, injury level, accompanying injuries, time between injury and surgery, follow-up time, complications, whether nerve reconstruction and artery repair were performed previously, and details of the procedure were recorded. The outcome measures were elbow range of motion in degrees, muscle strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and Short Form-36 (SF-36) scores. Results: The mean follow-up was 30 +/- 11.5 (range, 24 to 42) months. Two patients had C5-C8 injuries, two patients had C6-T1 injuries, and all other patients had injuries to the C5-T1 roots. Muscle strength was M3/M4 in 11 (68.8%) patients, M2 in two (12.5%) patients, and M0 in one (6.2%) patient. The median active range of motion of the elbow joint in patients with successful results (M3 and above) was measured as 75 (range, 30 to 100) degrees. A statistically significant improvement was observed in the pre-and postoperative DASH scores and in some SF-36 subscale scores of patients with successful results. Conclusion: Free gracilis muscle flap is a reliable option in the restoration of elbow flexion in patients with TBPP. Although there is an improvement in functional results, disability, and quality of life, there may be no change in patients' mental status and pain.
引用
收藏
页码:633 / 641
页数:9
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