Neurotization of free gracilis transfer with the brachialis branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury: an anatomical study and case report
| Autor: | Bengang Qin, Yi Hou, Xue-jun Zou, Xiangming Li, Guo Fu, Yi Yang, Ping Li, Jian Qi, Xiaolin Liu, Jiantao Yang, Liqiang Gu |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Inferior Trunk of the Brachial Plexus Injury Muscle Transfer medicine.medical_specialty Adolescent Tendon Transfer 030230 surgery Thumb Musculocutaneous nerve Fingers 03 medical and health sciences 0302 clinical medicine Gracilis Cadaver medicine Humans Brachial Plexus Brachialis Muscle Branch of the Musculocutaneous Nerve Range of Motion Articular Brachial Plexus Neuropathies Nerve Transfer lcsh:R5-920 Hand Strength business.industry Brachialis muscle General Medicine Anatomy Clinical Science medicine.disease Surgery body regions medicine.anatomical_structure Brachial plexus injury Gracilis Muscle Musculocutaneous Nerve Feasibility Studies Obturator nerve Brachialis lcsh:Medicine (General) business Brachial plexus 030217 neurology & neurosurgery |
| Zdroj: | Clinics, Vol 71, Iss 4, Pp 193-198 (2016) Clinics; v. 71 n. 4 (2016); 193-198 Clinics; Vol. 71 Núm. 4 (2016); 193-198 Clinics; Vol. 71 No. 4 (2016); 193-198 Clinics Universidade de São Paulo (USP) instacron:USP Clinics, Volume: 71, Issue: 4, Pages: 193-198, Published: APR 2016 |
| ISSN: | 1807-5932 1980-5322 |
| DOI: | 10.6061/clinics/2016(04)03 |
| Popis: | OBJECTIVE: To investigate the feasibility of using free gracilis muscle transfer along with the brachialis muscle branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury according to an anatomical study and a case report. METHODS: Thirty formalin-fixed upper extremities from 15 adult cadavers were used in this study. The distance from the point at which the brachialis muscle branch of the musculocutaneous nerve originates to the midpoint of the humeral condylar was measured, as well as the length, diameter, course and branch type of the brachialis muscle branch of the musculocutaneous nerve. An 18-year-old male who sustained an injury to the left brachial plexus underwent free gracilis transfer using the brachialis muscle branch of the musculocutaneous nerve as the donor nerve to restore finger and thumb flexion. Elbow flexion power and hand grip strength were recorded according to British Medical Research Council standards. Postoperative measures of the total active motion of the fingers were obtained monthly. RESULTS: The mean length and diameter of the brachialis muscle branch of the musculocutaneous nerve were 52.66±6.45 and 1.39±0.09 mm, respectively, and three branching types were observed. For the patient, the first gracilis contraction occurred during the 4th month. A noticeable improvement was observed in digit flexion one year later; the muscle power was M4, and the total active motion of the fingers was 209°. CONCLUSIONS: Repairing injury to the lower trunk of the brachial plexus by transferring the brachialis muscle branch of the musculocutaneous nerve to the anterior branch of the obturator nerve using a tension-free direct suture is technically feasible, and the clinical outcome was satisfactory in a single surgical patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|