Outcome of free gracilis muscle transfer for the restoration of elbow flexion in traumatic brachial plexus palsy


ARMANGİL M., Unsal S. S., Yildirim T., Bezirgan U., Keremov A., ADIYAMAN S., ...Daha Fazla

JOINT DISEASES AND RELATED SURGERY, cilt.32, sa.3, ss.633-641, 2021 (SCI-Expanded) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.52312/jdrs.2021.225
  • Dergi Adı: JOINT DISEASES AND RELATED SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.633-641
  • Anahtar Kelimeler: Brachial plexus paralysis, elbow flexion, free muscle transfer, neurotization, QUALITY-OF-LIFE, RECONSTRUCTION, NEUROTIZATION, INJURIES, TRANSPLANTATION, PARALYSIS, AVULSION
  • Ankara Üniversitesi Adresli: Evet

Özet

Objectives: The aim of this study was to evaluate the functional outcomes of patients with free gracilis muscle transfer (FGMT) for the restoration of elbow flexion. Patients and methods: Between January 2012 and January 2019, a total of 16 patients (13 males, 3 females; mean age: 27.3 +/- 11.7 years; range: 18 to 53 years) who underwent FGMF to achieve elbow flexion after traumatic brachial plexus palsy (TBPP) were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, etiology, affected side, injury level, accompanying injuries, time between injury and surgery, follow-up time, complications, whether nerve reconstruction and artery repair were performed previously, and details of the procedure were recorded. The outcome measures were elbow range of motion in degrees, muscle strength, and Disabilities of the Arm, Shoulder and Hand (DASH) and Short Form-36 (SF-36) scores. Results: The mean follow-up was 30 +/- 11.5 (range, 24 to 42) months. Two patients had C5-C8 injuries, two patients had C6-T1 injuries, and all other patients had injuries to the C5-T1 roots. Muscle strength was M3/M4 in 11 (68.8%) patients, M2 in two (12.5%) patients, and M0 in one (6.2%) patient. The median active range of motion of the elbow joint in patients with successful results (M3 and above) was measured as 75 (range, 30 to 100) degrees. A statistically significant improvement was observed in the pre-and postoperative DASH scores and in some SF-36 subscale scores of patients with successful results. Conclusion: Free gracilis muscle flap is a reliable option in the restoration of elbow flexion in patients with TBPP. Although there is an improvement in functional results, disability, and quality of life, there may be no change in patients' mental status and pain.