Elbow joint position sense following brachial plexus palsy treated with double free muscle transfer

Restoration of elbow flexion is the highest priority for brachial plexus reconstruction, and its reconstructive strategy is well established. The purpose of this article is to report elbow joint position sense (JPS) after double free muscle transfer (DFMT) for complete paralysis of brachial plexus.

Thirteen patients with complete brachial plexus paralysis who were treated with DFMT underwent evaluation of elbow JPS. JPS was measured as the subject's ability to actively reproduce a previously presented position of the elbow joint (target angle). We calculated the difference between target and reproduced angle and defined this as the absolute error (AE). Ten healthy control subjects participated in this study.

In control subjects, mean AE measured 4 degrees +/- 1 degree at the target angle of 60 degrees and 4 degrees +/- 2 degrees at 80 degrees. After DFMT, patients' mean AE measured 5 degrees +/- 2 degrees at the target angle of 60 degrees and 5 degrees +/- 3 degrees at 80 degrees. There was no statistical difference between the control and DFMT groups at target angles of 60 degrees and 80 degrees.

Patients with complete paralysis of the brachial plexus had evidence of elbow JPS after successful restoration of elbow flexion after DFMT. Although this study provides us with useful information regarding the perception of elbow JPS, further study is necessary to confirm the exact mechanism of perception of elbow JPS.

Therapeutic IV.