Free Functioning Gracilis Muscle Transfer For Reconstruction Of Elbow Flexion After Later Brachial Plexus Injury

Objective: to study clinical assessment of Free functioning gracilis muscle transfer to reconstruct elbow flexion after later brachial plexus injury.Methods: This was a prospective study of a series of gracilis transfer proceduresin 12 men having an average age of 25.6 years(23—37)and average follow-up of 112 months.The patients were operated on average at 15 months following their motor vehicle accident;five had a partial paralysis(C5C6C7)and seven had a complete paralysis(C5-T1).The surgical technique and rehabilitation protocol were the same for all the patients.Results: There were one case of infectious necrosis(17%)that led to functional fail-ure.When these the case were excluded from the analysis,all the remaining patients had auseful result(British Medical Research Council score?M4)and 2.5kg of elbow flexion strength measured on a dynamometer.The strength was 3.8kg(2.7 to 55)for partial plexus injuries and 1.6kg(0.3to 1.5)for complete plexus injuries.For partial injuries,active elbow flexion was 128 ?and extension-38 ?,versus 103 ? and-23 ? for complete injuries.The average DASH score was 42 for partial injuries and 32 for complete injuries.Conclusion: late BPI patients can gain M3 muslce strength and large scale of elbow flexion by reconstructing elbow flexion with gracilis muscle transfer...