Musculocutaneous neurotization to restore elbow flexion in brachial plexus paralysis

Microsurgery
M D VekrisPanayotis N Soucacos

Abstract

Brachial plexus injuries may result in devastating paralysis, especially if they involve all the roots. The upper roots are often traumatized, and therefore elbow flexion is usually lost. The prognosis of these injuries is grave if root avulsions are present and the paralysis includes the hand as well. The current management of brachial plexus injuries should be early, aggressive microsurgical reconstruction of the plexus, combining various neurotizations with intraplexus and extraplexus nerve donors. Following this principle, we present the results of musculocutaneous neurotization in our unit, as well as a review of the literature on this subject. Our results are comparable to those reported in the literature, and indicate that the strongest function is achieved after neurotization via intraplexus donors, while some extraplexus donors (i.e., phrenic and accessory nerve) can offer equally strong elbow flexion, especially if they are used in combination. Neurotization of the musculocutaneous nerve should be one of the primary goals in the reconstruction of the injured plexus, since the return of elbow flexion is of paramount importance in daily activity. The restoration of function is ensured if the stronger and healthier motor...Continue Reading

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Mar 5, 2003·Microsurgery·Tarek Abdalla El-GammalMohammed M Kotb

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Citations

Nov 11, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Julia K Terzis, Antonia Barbitsioti
Jul 14, 2010·The Journal of Hand Surgery·Mou-Xiong ZhengYu-Dong Gu
Dec 22, 2020·Annals of Plastic Surgery·Tarek Abdalla El-GammalYousif Tarek El-Gammal
Apr 25, 2021·Prilozi·Sofija PejkovaBlagoja Srbov

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