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Related Experiment Videos

Muscle transfers in brachial plexus lesions.

A Berger1, P J Flory, E Schaller

  • 1Clinic of Plastic, Hand, and Reconstructive Surgery, Medical School of Hannover, West Germany.

Journal of Reconstructive Microsurgery
|April 1, 1990
PubMed
Summary
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This study presents a two-stage surgical reconstruction for brachial plexus injuries, combining vascularized nerve grafts with muscle transfers. The novel approach aims to restore elbow and finger flexion in patients with severe nerve damage.

Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Neuroreconstruction

Background:

  • Brachial plexus lesions often result in significant functional loss.
  • Restoring function requires complex and broad reconstructive strategies.
  • Previous surgical interventions may yield suboptimal outcomes.

Purpose of the Study:

  • To explore novel clinical concepts for brachial plexus reconstruction.
  • To evaluate a two-stage surgical approach combining vascularized nerve grafts and autologous muscle transfer.
  • To improve functional recovery in patients with severe brachial plexus injuries.

Main Methods:

  • A two-stage surgical procedure was developed.
  • Stage 1 involves preparing the ulnar nerve as a vascularized nerve graft and suturing it to intercostal nerves.

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  • Stage 2 utilizes a microvascularly transferred latissimus dorsi muscle, connected to forearm flexors and the brachial vessels, with the thoracodorsal nerve sutured to the graft.

    • Main Results:

    • The described method facilitates reconstruction for late complete root avulsions and previously operated cases with poor functional return.
    • The surgical technique aims to restore both elbow and finger flexion.
    • Experience with 160 patients supports the feasibility and potential efficacy of this approach.

    Conclusions:

    • This combined vascularized nerve graft and muscle transfer technique offers a comprehensive solution for brachial plexus reconstruction.
    • The two-stage approach addresses complex cases, including root avulsions and functional deficits.
    • The method shows promise in restoring crucial upper extremity functions like elbow and finger flexion.