A prospective study comparing single and double fascicular transfer to restore elbow flexion after brachial plexus injury. 2013

Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
Peripheral Nerve Surgery Unit, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil. robar@ig.com.br

BACKGROUND The recovery of elbow flexion in upper brachial plexus injury can be achieved by the reinnervation of the biceps muscle (single reinnervation), but concomitant restoration of brachialis and biceps function (double reinnervation) has been recommended to improve elbow flexion strength. OBJECTIVE To prospectively compare morbidity and outcomes of single or double muscle reinnervation in restoring elbow flexion following incomplete injury to the brachial plexus. METHODS Forty consecutive patients were prospectively submitted to single or double muscle reinnervation. Elbow flexion strength was evaluated with a push-and-pull dynamometer 12 months after surgery. Hand morbidity related to the procedures was evaluated by the Semmes-Weinstein monofilaments test, quantification of static 2-point discrimination, and measurements of handgrip and lateral pinch strength in serial evaluations up to the final follow-up. RESULTS Similar results for the strength of elbow flexion were observed in both groups. A worsening of sensibility, measured by using Semmes-Weinstein monofilaments, was identified in 8 patients, all of whom showed recovery during follow-up. No worsening of 2-point discrimination was observed. A decrease in handgrip and lateral pinch strength was identified in 8 and 9 patients, respectively, which improved during follow-up. There was no difference between the groups in the incidence of hand motor morbidity parameters. CONCLUSIONS The strength of elbow flexion did not differ significantly between the groups treated with single or double muscle reinnervation. Deterioration of handgrip, lateral pinch strength, and sensibility measured by using Semmes-Weinstein monofilaments, was temporary, resulting in low morbidity for both techniques.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D001917 Brachial Plexus The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. Plexus, Brachial
D004551 Elbow Joint A hinge joint connecting the FOREARM to the ARM. Elbow Joints,Joint, Elbow,Joints, Elbow
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000092464 Elbow Injuries Injuries involving the ELBOW and ELBOW JOINT. Elbow Joint Injuries,Elbow Injury,Elbow Joint Injury,Injury, Elbow,Injury, Elbow Joint,Joint Injury, Elbow
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

Related Publications

Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
April 2019, Cureus,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
August 1988, The Journal of bone and joint surgery. British volume,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
July 2017, Neurosurgical focus,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
May 2023, Journal of reconstructive microsurgery,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
December 2011, Orthopaedics & traumatology, surgery & research : OTSR,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
November 2016, Journal of the Medical Association of Thailand = Chotmaihet thangphaet,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
October 2006, Plastic and reconstructive surgery,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
March 2006, Plastic and reconstructive surgery,
Roberto Sergio Martins, and Mario Gilberto Siqueira, and Carlos Otto Heise, and Luciano Foroni, and Manoel Jacobsen Teixeira
January 2011, Plastic and reconstructive surgery,
Copied contents to your clipboard!