Related Experiment Video
Updated: Jun 28, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Free functional gracilis muscle transfer in children with severe sequelae from obstetric brachial plexus palsy
Jörg Bahm1, Claudia Ocampo-Pavez
1Euregio Reconstructive Microsurgery Unit, Franziskushospital, Aachen, Germany. jorg.bahm@belgacom.net
Insights
Free functional gracilis muscle transfer successfully restored active long finger flexion in children with severe obstetric brachial plexus palsy. This microsurgical technique offers a solution for patients lacking lower trunk neurotization.
Area of Science:
- Pediatric Surgery
- Microsurgery
- Orthopedic Surgery
Background:
- Obstetric brachial plexus palsy (OBPP) can lead to severe hand dysfunction, including absent active long finger flexion.
- Early microsurgical nerve reconstruction is crucial for managing OBPP, but some cases lack lower trunk neurotization.
- Restoring finger flexion is a significant challenge in managing the sequelae of OBPP.
Observation:
- Four children aged 6-13 years with total OBPP and no functional active long finger flexion were treated.
- These children had previously undergone early microsurgical nerve reconstruction without lower trunk neurotization.
- A free functional gracilis muscle transfer was performed to reanimate long finger flexion.
Findings:
- The study successfully reanimated active long finger flexion in all four children using the gracilis muscle transfer.
- This complex microsurgical procedure demonstrated positive functional outcomes for severe OBPP sequelae.
- The gracilis muscle transfer effectively addressed the lack of active finger flexion caused by brachial plexus injury.
Implications:
- Free functional gracilis muscle transfer is a viable and effective option for restoring hand function in select OBPP cases.
- This technique expands reconstructive possibilities for severe obstetric brachial plexus palsy, particularly when nerve reconstruction alone is insufficient.
- Further research into the long-term outcomes and indications for this procedure is warranted.
Abstract:
We present 4 children between 6 and 13 years suffering from severe sequelae after a total obstetric brachial plexus lesion resulting in a hand without functional active long finger flexion. They had successfully reanimated long finger flexion using a free functional gracilis muscle transfer. These children initially presented a total obstetric brachial plexus palsy without neurotisation of the lower trunk in an early microsurgical nerve reconstruction procedure. We describe our indications for this complex microsurgical procedure, the surgical technique and the outcome.
