Gouda, M., Ahmed, M. (2024). Free Functional Gracilis for Restoration of Elbow Flexion in Late Brachial Plexus Palsy. The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), 197-204. doi: 10.21608/ejprs.2024.365329
Mahmoud E Gouda; Mohammad R Ahmed. "Free Functional Gracilis for Restoration of Elbow Flexion in Late Brachial Plexus Palsy". The Egyptian Journal of Plastic and Reconstructive Surgery, 48, 3, 2024, 197-204. doi: 10.21608/ejprs.2024.365329
Gouda, M., Ahmed, M. (2024). 'Free Functional Gracilis for Restoration of Elbow Flexion in Late Brachial Plexus Palsy', The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), pp. 197-204. doi: 10.21608/ejprs.2024.365329
Gouda, M., Ahmed, M. Free Functional Gracilis for Restoration of Elbow Flexion in Late Brachial Plexus Palsy. The Egyptian Journal of Plastic and Reconstructive Surgery, 2024; 48(3): 197-204. doi: 10.21608/ejprs.2024.365329
Free Functional Gracilis for Restoration of Elbow Flexion in Late Brachial Plexus Palsy
The Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Zagazig University
Abstract
Background: Functional restoration of elbow flexion represents a major reconstructive challenge for post-traumatic adult brachial plexus injuries. Free functional muscle transfer (FFMT) is the only hope in patients with a lack of local donor tissues or delayed presentation. Objective: To study the outcome of free functional gracilis for restoration of elbow flexion in late brachial plexus palsy. Methods: A retrospective review of 15 patients who underwent free functioning muscle transfer for elbow flexion as part of their brachial plexus injury reconstruction with an average of 22-month follow-up period. Report of the clinical outcomes of flap viability and the degree of elbow flexion restoration by range of motion and British Medical Research Council (MRC) grade. Results: The average age was 37 years, and 60% were caused by Road Traffic Accidents. The flap survival rate reached 86.6% (n=13). The mean follow-up period was 22 months (range, 12-30 months). By the end of the follow-up period, 69% of the transfers had recovered MRC grade >M3 elbow flexion strength. They could lift an average of 2.7kg (range, 0.5-5kg). Conclusion: The use of FFMT using the gracilis muscle is a reliable procedure in the restoration of elbow flexion in patients with brachial plexus injuries beyond 12 months from the time of injury and in patients with complete root avulsion injuries. In the hands of an experienced team, good results can be achieved.
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