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Related Experiment Videos

Functional outcome after the L'Episcopo procedure

M Beauchamp1, D E Beaton, T A Barnhill

  • 1Upper Extremity Reconstructive Service, St. Michael's Hospital and the University of Toronto, Ontario, Canada.

Journal of Shoulder and Elbow Surgery
|May 21, 1998
PubMed
Summary
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The L'Episcopo procedure effectively restores shoulder function in patients with brachial plexus injuries. This muscle-tendon transfer improved daily activities and external rotation, making it a worthwhile option for late reconstruction.

Area of Science:

  • Orthopedic Surgery
  • Neurosurgery
  • Rehabilitation Medicine

Background:

  • Adult-onset brachial plexus injuries often result in external rotation deficiency of the shoulder.
  • Restoring shoulder function is crucial for activities of daily living and return to work.

Purpose of the Study:

  • To evaluate the functional outcomes of the L'Episcopo procedure (latissimus dorsi and teres major transfer) in patients with external rotation deficient shoulders.
  • To assess the efficacy of this procedure in late functional reconstruction following adult-onset brachial plexus injuries.

Main Methods:

  • A cohort of 11 patients with adult-onset brachial plexus injuries underwent the L'Episcopo procedure.
  • Patients were assessed pre- and post-operatively using questionnaires, range of motion measurements, strength testing, and an overhead work simulation.

Related Experiment Videos

  • Mean follow-up time and time from injury to operation were recorded.

    • Main Results:

    • Significant improvements were observed in the Activities of Daily Living (ADL) scores (14 to 20).
    • Ten of eleven patients returned to work, with eight resuming pre-injury employment.
    • Mean active external rotation improved, and 7/9 patients completed the overhead work simulation.

    Conclusions:

    • The L'Episcopo procedure is a reliable and effective surgical option for late functional reconstruction in adult-onset brachial plexus injuries.
    • The transfer consistently improves shoulder external rotation, strength, and overall functional outcomes.
    • No complications were reported, and patients reported high satisfaction and confidence in their limb.