Free functioning muscle transfer in radiation-induced brachial plexopathy: case report
Bipin A Gangurde1, Kazuteru Doi1, Yasunori Hattori1
1Department of Orthopedics, Ogori Daiichi General Hospital, Yamaguchi, Japan.
The Journal of Hand Surgery
|August 27, 2014
Summary
Radiation-induced brachial plexopathy, a delayed complication of cancer treatment, can be treated with muscle transfer surgery. This procedure successfully restored elbow flexion and hand function in a patient 15 years post-radiation.
Area of Science:
- Neurology
- Oncology
- Plastic Surgery
Background:
- Radiation-induced brachial plexopathy is a progressive, delayed complication following radiation therapy for neck and chest cancers.
- It significantly impacts upper extremity function, affecting daily living activities.
Observation:
- A 56-year-old woman presented with loss of elbow flexion and weak hand function 15 years after radiation for breast cancer.
- Her symptoms were consistent with radiation-induced brachial plexopathy affecting the left arm.
Findings:
- The patient underwent a gracilis free muscle transfer to restore elbow flexion and hand prehension.
- Two years post-surgery, she regained significant elbow range of motion (40°-110°) and improved hand function.
- Her Disabilities of the Arm, Shoulder, and Hand (DASH) score improved from 56 to 20, indicating substantial functional recovery.
Implications:
- Gracilis free muscle transfer is an effective surgical option for managing long-term radiation-induced brachial plexopathy.
- Restoration of upper extremity function can significantly improve a patient's quality of life and independence in daily activities.
