Significance of shoulder function in the reconstruction of prehension with double free-muscle transfer after complete paralysis of the brachial plexus.

Abstract:

:Reconstruction of shoulder stability and movement in cases with complete paralysis of the brachial plexus was performed to improve the outcomes for universal function of prehension after double free-muscle transfer (Doi's procedure). In cases in which the C5 or C6 nerve root was available as a donor, neurotization of the supra-scapular nerve was performed with a nerve graft. If the C5 or C6 nerve root was not available, then the contralateral C7 nerve root was chosen as the donor motor nerve and was transferred to the suprascapular nerve by using a vascularized ulnar nerve graft. Seven cases with ipsilateral C4, C5, or C6 nerve root transfer to the suprascapular nerve and one with contralateral C7 transfer were evaluated, and the functional outcomes for the range of shoulder motion were compared with those for patients who had undergone arthrodesis of the humeroscapular joint or had undergone no procedures for shoulder function reconstruction. The patients who underwent supra-scapular nerve repair demonstrated statistically significantly better ranges of motion for flexion and abduction of the shoulder, compared with the other two groups. Shoulder function is important for achieving prehensile function among patients with complete paralysis of brachial function, when they undergo double free-muscle transfer.

journal_name

Plast Reconstr Surg

authors

Doi K,Hattori Y,Ikeda K,Dhawan V

doi

10.1097/01.PRS.0000085820.24572.EE

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

1596-603

issue

6

eissn

0032-1052

issn

1529-4242

journal_volume

112

pub_type

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