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Operations to restore elbow flexion after brachial plexus injuries
R W Marshall1, D H Williams, R Birch
1St Mary's Hospital, London, England.
The Journal of Bone and Joint Surgery. British Volume
|August 1, 1988
Summary
Restoring elbow flexion after brachial plexus traction injuries using muscle transfers yielded high patient satisfaction but poor objective muscle power. Latissimus dorsi and triceps transfers were most reliable for improving function.
Area of Science:
- Orthopedic Surgery
- Neurology
- Rehabilitation Medicine
Background:
- Traction injuries to the brachial plexus can cause significant loss of elbow flexion.
- Restoring elbow flexion is crucial for upper limb function and patient quality of life.
Purpose of the Study:
- To evaluate the long-term functional outcomes of various surgical procedures for restoring elbow flexion after brachial plexus traction injuries.
- To identify the most effective surgical techniques and factors influencing functional recovery.
Main Methods:
- Retrospective review of 50 patients undergoing operations for elbow flexion restoration.
- Mean follow-up period of 2.7 years.
- Assessment of patient satisfaction, objective muscle power, and functional improvement, considering shoulder control.
Main Results:
- High patient satisfaction reported overall.
- Objective assessment revealed poor muscle power in transferred muscles; less than half achieved significant functional improvement.
- Latissimus dorsi and triceps transfers were the most reliable.
- Steindler flexorplasties showed some satisfactory results.
- Pectoralis major transfers were disappointing, particularly in women.
Conclusions:
- While patient satisfaction is often high, surgical restoration of elbow flexion after brachial plexus injuries has limitations in objective functional gains.
- Latissimus dorsi and triceps transfers are recommended for their reliability.
- Pectoralis major transfers are not recommended for women due to disappointing outcomes.