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Related Concept Videos

Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...

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Surface Electromyographic Biofeedback as a Rehabilitation Tool for Patients with Global Brachial Plexus Injury Receiving Bionic Reconstruction
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Treatment of Complete Brachial Plexus Injuries Using Double Free Muscle Transfer.

Ryosuke Kakinoki1, Kazuhiro Ohtani1, Souichi Ohta2

  • 1Department of Orthopedic Surgery, Kindai University Hospital, Osaka, Japan.

The Journal of Hand Surgery
|November 3, 2023
PubMed
Summary

Double free muscle transfer (DFMT) surgery improved elbow flexion and hand function in patients with complete brachial plexus injury (BPI). This surgical technique offers good outcomes for severe nerve damage.

Keywords:
Brachial plexus injurydouble free muscle transfermuscle transplantationnerve transfer

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Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Reconstructive Surgery

Background:

  • Complete brachial plexus injury (BPI) results in significant upper limb dysfunction.
  • Restoring function after BPI, especially complete injuries, remains a surgical challenge.
  • Double free muscle transfer (DFMT) is a reconstructive option for severe BPI.

Purpose of the Study:

  • To evaluate the surgical outcomes of DFMT in patients with complete BPI.
  • To assess functional recovery, including range of motion and sensation, after DFMT.
  • To analyze patient-reported outcomes and pain levels post-surgery.

Main Methods:

  • Retrospective analysis of 12 patients with complete BPI undergoing DFMT.
  • Follow-up exceeding 2 years post-final muscle transplantation.
  • Measurement of shoulder, elbow, and finger range of motion (ROM).
  • Assessment of patient-reported outcomes using DASH and VAS scores.

Main Results:

  • Significant improvements in elbow flexion (mean 111°) and shoulder ROM (abduction 22°, flexion 33°).
  • All patients achieved functional hand hook grasp and touch sensation.
  • Postoperative DASH scores improved, indicating reduced disability.
  • Phrenic nerve transfer in some patients resulted in asymptomatic lung impairment.

Conclusions:

  • DFMT is an effective surgical intervention for complete brachial plexus palsy.
  • The procedure yields good elbow flexion and hand hook function.
  • DFMT offers functional restoration for patients with severe BPI.