Free muscle transfer in posttraumatic plexopathies: part III. The hand

Plastic and Reconstructive Surgery
Julia K Terzis, Vasileios K Kostopoulos

Abstract

In lower root avulsion plexopathies, free muscle transfers for hand reanimation provide the only hope for the paralyzed hand, as the outcomes of hand functional restoration after primary brachial plexus reconstruction are uniformly poor. The purpose of this study was to analyze the outcomes of free gracilis muscle transfers for hand reanimation in severe brachial plexus injuries in relation to the respective motor donors. Since 1981, 71 free gracilis muscles have been transplanted for hand reanimation. Thirty-eight were for finger flexion and 33 were for finger extension. Neurotizations included motor donors such as intercostal nerves (n = 29), contralateral C7 root (n = 28), spinal accessory nerve (n = 7), or upper roots of the ipsilateral plexus (n = 5). Preoperative and postoperative muscle grading and range of motion were found to be significantly different. The strongest motor donor for finger extension was the distal spinal accessory. The medial antebrachial cutaneous nerve as a conduit nerve carrying motor axons yielded worse results than other motor donors. Intercostals were useful for finger flexion and the contralateral C7 root was useful for finger extension. Scar formation in the volar wrist area was frequently a pr...Continue Reading

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Apr 2, 2009·Plastic and Reconstructive Surgery·Julia K Terzis, Vasileios K Kostopoulos

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Citations

Apr 20, 2014·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Keiichi MuramatsuToshihiko Taguchi
Oct 7, 2009·Hand : Official Journal of the American Association for Hand Surgery·Julia K Terzis, Vasileios K Kostopoulos
Nov 12, 2013·Hand Clinics·David Ruta, Kagan Ozer
Jul 28, 2012·Surgical Oncology·Keiichi MuramatsuToshihiko Taguchi
Oct 29, 2011·Clinics in Plastic Surgery·Alexander Seal, Milan Stevanovic
Oct 29, 2011·Clinics in Plastic Surgery·Laurent WehrliDimitri J Anastakis
Apr 21, 2016·Hand Clinics·Emily M KraussAmy M Moore
Jul 9, 2016·Hand Clinics·Ryan M Garcia, David S Ruch
Jan 18, 2017·Journal of Neurosurgery·Laura A HrubyOskar C Aszmann
Dec 11, 2020·Plastic and Reconstructive Surgery. Global Open·Steven T LanierChristopher J Dy

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