Transfer of the recovered biceps to the long flexors of the digits to restore grip function following complete traumatic brachial plexus palsy

Oberlin, C.; Durand, S.; Fox, Michael; Belkheyar, Zoubir

doi:10.1016/j.main.2010.03.010

Cited by 9 publications

(3 citation statements)

References 11 publications

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“…In another patient, the stability provided by the triceps allowed for fusion of the wrist and transfer of biceps to the flexor digitorum profundus to produce flexion of the fingers. Recently, Oberlin et al 30. published seven cases treated with the same technique and we present our results of two patients as a part of this cohort study.…”

Section: Discussionmentioning

confidence: 86%

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Nerve reconstruction: A cohort study of 93 cases of global brachial plexus palsy

Bhatia

Shyam²,

Doshi

et al. 2011

IJOO

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Introduction:Brachial plexus injury leading to flail upper limb is one of the most disabling injuries. Neglect of the injury and delay in surgeries may preclude reinnervation of the paralysed muscles. Currently for such injuries nerve transfers are the preferred procedures. We here present a series of 93 cases of global brachial plexus palsy treated with nerve transfers.Materials and Methods:Ninety-three cases of global palsies out of 384 cases of brachial plexus injury operated by the senior surgeon (AB) were selected. Age varied from 4 to 51 years with 63 patients in 20 to 40 age group and all patients having a minimum follow up of at least 1 year post surgery ranging up to 130 months. The delay before surgery ranged from 15 days to 16 months (mean 3.2 months). The aim of the surgery was to restore the elbow flexion, shoulder abduction, triceps function and wrist and finger flexion in that order of priority. The major nerve transfers used were spinal accessory to suprascapular nerve, intercostal to musculocutaneous nerve and pectoral nerves, contralateral C7 to median and radial nerves. Nerve stumps were used whenever available (30 patients).Results:Recovery of ≥ grade 3 power was noted in biceps in 73% (68/93) of patients, shoulder abduction in 89% (43/49), pectoralis major in 100% (8/8). Recovery of grade 2 triceps power was seen in 80% (12/16) patients with nerve transfer to radial nerve. Derotation osteotomies of humerus (n=13) and wrist fusion (n=14) were the most common secondary procedures performed to facilitate alignment and movements of the affected limb. Better results were noted in 59 cases where direct nerve transfers were done (without nerve graft).Conclusion:Acceptable function (restoration of biceps power ≥3) can be obtained in more than two thirds (73%) of these global brachial plexus injuries by using the principles of early exploration and nerve transfer with rehabilitation.

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Section: Discussionmentioning

confidence: 86%

“…We have started to explore these options too and early results look promising. We have already used the technique of Oberlin et al 30. to achieve acceptable distal function in two patients.…”

Section: Discussionmentioning

confidence: 99%

Nerve reconstruction: A cohort study of 93 cases of global brachial plexus palsy

Bhatia

Shyam²,

Doshi

et al. 2011

IJOO

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“…[ 9 ] Biceps (reinnervated or normal) or the brachialis has also been used for transfer to the FDP tendons but with the addition of a tendon graft usually harvested as a fascia lata graft. [ 10 11 ]…”

Section: Discussionmentioning

confidence: 99%

Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

Srikanth

Rayidi

Kakumanu

2018

Indian J Plast Surg

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Introduction:The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis.Materials and Methods:Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up.Results:Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range.Conclusion:The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.

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Pediatric Brachial Plexus Repair in Late Presentations

Gilbert

2015

Nerves and Nerve Injuries

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Transfer of the recovered biceps to the long flexors of the digits to restore grip function following complete traumatic brachial plexus palsy

Cited by 9 publications

References 11 publications

Nerve reconstruction: A cohort study of 93 cases of global brachial plexus palsy

Nerve reconstruction: A cohort study of 93 cases of global brachial plexus palsy

Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

Pediatric Brachial Plexus Repair in Late Presentations

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