Reconstruction of elbow flexion with a modified Oberlin procedure: A comparative study
Zinon T Kokkalis1, Aikaterini Bavelou1, Efstratios Papanikos1
1Department of Orthopaedics, University of Patras, School of Medicine, University Hospital of Patras, Patras, Greece.
Injury
|November 1, 2019
Summary
A modified Oberlin technique for upper brachial plexus injuries successfully restores elbow flexion by transferring two ulnar nerve fascicles. This double fascicle transfer method shows favorable results compared to the classic procedure.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Microsurgery
Background:
- Upper brachial plexus injuries (C5-C6-C7) often require nerve transfer techniques.
- The classic Oberlin procedure involves transferring one ulnar nerve fascicle to the biceps motor branch.
- A modified approach aims to improve outcomes for elbow flexion restoration.
Purpose of the Study:
- To present a modified Oberlin technique for upper brachial plexus injuries.
- To compare the outcomes of the modified technique with the classic Oberlin procedure.
Main Methods:
- Two patient groups were analyzed: 16 treated with the classic Oberlin procedure and 5 with a modified technique.
- The modified technique involved transferring two ulnar nerve fascicles to both the biceps and brachialis motor branches.
- Surgeons performing the procedures were different for each group.
Main Results:
- Classic Oberlin: 93.75% achieved MRC grade 4 biceps strength.
- Modified Oberlin: 80% achieved MRC grade 4+ and 20% achieved MRC grade 4 strength, with mean elbow strength of 5.4 kg.
- No adverse effects on the ulnar nerve territory were observed in either group.
Conclusions:
- The modified Oberlin technique successfully innervates both elbow flexors while preserving the median nerve.
- This double fascicle transfer technique yields favorable results for restoring strong elbow flexion.
- The modified technique is proposed as an effective option for managing upper brachial plexus injuries.
