Hamza, F., Abdel Moktader, M., Ahmed, R., ALTAMIMY, H., Nassef, M., Eldosokey, M. (2020). Neurotization for Elbow Flexion Restoration after Brachial Plexus Injury. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), 509-515. doi: 10.21608/ejprs.2020.68210
Fawzi A Hamza; Magdy A Abdel Moktader; Reda M Ahmed; Hegazy M ALTAMIMY; Mahmoud A Nassef; Mahmoud A Eldosokey. "Neurotization for Elbow Flexion Restoration after Brachial Plexus Injury". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 3, 2020, 509-515. doi: 10.21608/ejprs.2020.68210
Hamza, F., Abdel Moktader, M., Ahmed, R., ALTAMIMY, H., Nassef, M., Eldosokey, M. (2020). 'Neurotization for Elbow Flexion Restoration after Brachial Plexus Injury', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(3), pp. 509-515. doi: 10.21608/ejprs.2020.68210
Hamza, F., Abdel Moktader, M., Ahmed, R., ALTAMIMY, H., Nassef, M., Eldosokey, M. Neurotization for Elbow Flexion Restoration after Brachial Plexus Injury. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 43(3): 509-515. doi: 10.21608/ejprs.2020.68210
Neurotization for Elbow Flexion Restoration after Brachial Plexus Injury
1The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Al-Azhar University
2The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Al-Azhar university
3The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Zagazig University
4The Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine, Al-Azhar University
5The Department of Plastic & Reconstructive Surgery, Al-Ahrar Teaching Hospital4, Cairo, Egypt
Abstract
Background: Restoration of elbow flexion after brachial plexus injury has the first priority in adults. Nerve transfers (neurotization) involves taking nerves with less important functions or branches of a nerve that perform redundant functions to restore important function in a more crucial nerve that has been severely damaged. There are many described neurotization methods for elbow flexion restoration like Oberlin method, Double Fascicular Transfer (DFT) and Intercostal Nerves (ICN) transfer. The aim of this study was to evaluate different methods of nerve transfer for restoration of elbow flexion after brachial plexus injury. Patients and Methods: 21traumatic BPI were included in this study (19 unilateral BPI and 1 bilateral BPI). 4 patients were operated by Oberlin method, 5 by DFT and 12 by ICN transfer. Results: 3 primary procedures were used. Oberlin method in 4 cases (19.0%) 3 cases (75%) give results M3 or more. DFT method in 5 cases (23.8%) all of them give results M3 or more. ICN transfer in 12 cases (57.1%) 9 cases (75%) give results M3 or more. Conclusion: In upper BPI, DFT is the first option due to effectiveness without noticeable donor functional affection and Oberlin method is the 2nd option if median nerve has functional deficit or not well recovered or has been used in another transfer as in (c5, c6 and c7) cases. Three ICNs transfer to musculocutaneous nerve without nerve graft in total BPI is advisable due to effectiveness and least morbidity.
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