scholarly journals The effects of denervation, reinnervation, and muscle imbalance on functional muscle length and elbow flexion contracture following neonatal brachial plexus injury

2012 ◽  
Vol 30 (8) ◽  
pp. 1335-1342 ◽  
Author(s):  
Holly Weekley ◽  
Sia Nikolaou ◽  
Liangjun Hu ◽  
Emily Eismann ◽  
Christopher Wylie ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Muscle Length ◽  
Elbow Flexion ◽  
Flexion Contracture ◽  
Muscle Imbalance

Developing a Decision Aid for Youth with Brachial Plexus Birth Injuries Facing Treatment Decisions for an Elbow Flexion Contracture

PM&R ◽  
2021 ◽  
Author(s):  
Emily S. Ho ◽  
Janet A. Parsons ◽  
Kristen Davidge ◽  
Howard M. Clarke ◽  
Margaret L. Lawson ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Decision Aid ◽  
Elbow Flexion ◽  
Treatment Decisions ◽  
Flexion Contracture ◽  
Birth Injuries

Does technical components of microanastomoses influence the functional outcome of free gracilis muscle transfer for elbow flexion in traumatic brachial plexus injury?

2021 ◽  
pp. 102827
Author(s):  
Francisco Vilmar Felix Martins-Filho ◽  
Fernanda do Carmo Iwase ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Functional Outcome ◽  
Brachial Plexus Injury ◽  
Elbow Flexion ◽  
Gracilis Muscle ◽  
Muscle Transfer

Minimum Ten-Year Outcomes of Partial Ulnar Nerve Transfer for Restoration of Elbow Flexion in Patients with Upper Brachial Plexus Injury

2019 ◽  
Vol 24 (03) ◽  
pp. 283-288
Author(s):  
Yusuke Nagano ◽  
Daisuke Kawamura ◽  
Alaa Terkawi ◽  
Atsushi Urita ◽  
Yuichiro Matsui ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Functional Outcomes ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
The Mean ◽  
Flexion Strength

Background: Partial ulnar nerve transfer to the biceps motor branch of the musculocutaneous nerve (Oberlin’s transfer) is a successful approach to restore elbow flexion in patients with upper brachial plexus injury (BPI). However, there is no report on more than 10 years subjective and objective outcomes. The purpose of this study was to clarify the long-term outcomes of Oberlin’s transfer based on the objective evaluation of elbow flexion strength and subjective functional evaluation of patients. Methods: Six patients with BPI who underwent Oberlin’s transfer were reviewed retrospectively by their medical records. The mean age at surgery was 29.5 years, and the mean follow-up duration was 13 years. The objective functional outcomes were evaluated by biceps muscle strength using the Medical Research Council (MRC) grade at preoperative, postoperative, and final follow-up. The patient-derived subjective functional outcomes were evaluated using the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at final follow-up. Results: All patients had MRC grade 0 (M0) or 1 (M1) elbow flexion strength before operation. Four patients gained M4 postoperatively and maintained or increased muscle strength at the final follow-up. One patient gained M3 postoperatively and at the final follow-up. Although one patient achieved M4 postoperatively, the strength was reduced to M2 due to additional disorder. The mean score of QuickDASH was 36.5 (range, 7–71). Patients were divided into two groups; three patients had lower scores and the other three patients had higher scores of QuickDASH. Conclusions: Oberlin’s transfer is effective in the restoration of elbow flexion and can maintain the strength for more than 10 years. Patients with upper BPI with restored elbow flexion strength and no complicated nerve disorders have over ten-year subjective satisfaction.

scholarly journals Correlation of compound muscle action potential generated by donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury

2018 ◽  
Vol 51 (02) ◽  
pp. 137-144
Author(s):  
Mukund Ramchandra Thatte ◽  
Binita Bharat Raut ◽  
Amita Shivyogi Hiremath ◽  
Sushil Ramesh Nehete ◽  
Nayana Somala Nayak
Keyword(s):  
Action Potential ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Compound Muscle Action Potential ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Muscle Action ◽  
Muscle Action Potential ◽  
Group A ◽  
Group B

ABSTRACT Objective: To study the correlation of compound muscle action potential of donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury. Introduction: Distal nerve transfer using motor fascicle of ulnar or median nerve to restore elbow flexion is a part of reconstructive surgery after upper brachial plexus injury, first described by Oberlin et al. However, one of the most critical influences on functional outcome is number of functioning motor axons in donor fascicle which is reflected by its compound muscle action potential. We studied whether nerve transfers with donor nerves showing higher amplitudes will yield better reinnervation of muscle and therefore better function as estimated by clinical examination. Methods: We prospectively studied 30 cases of upper brachial plexus injury, of which were treated with Oberlin transfer using ulnar or median or both nerves. The prerequisites were no elbow flexion and hand and wrist flexors showing the power of more than Medical research Council MRC Grade 4. Donor nerves selected either ulnar or median having CMAP >4 mv in our electrophysiology laboratory during nerve conduction study. Patients were followed up for 1 year and assessed clinically for restoration of elbow flexion, weight tolerance. Results: A total of 30 patients of Oberlin transfer were evaluated for improvement power of biceps and elbow flexion. (MRC) grading was done at 1 year. Twenty-seven patients had a good result (MRC grade ≥3), i.e., 90% of patients. Based on the MRC grades, we categorised the patients into two groups as follows: Group A and Group B. Group A included patients with MRC Grade 4–5 and Group B included Grades 3–3.5. We tried to establish a correlation between CMAP and MRC scores by comparison of MRC grade patients for their pre CMAPs which revealed a statistically significant higher CMAPs between the groups. (Mann–Whitney U-test, P = 0.028). This indicates the association of higher pre-CMAPs with higher MRC grades. Conclusion: We conclude that higher the compound muscle action potential of donor nerves, better the recovery of elbow flexion in Oberlin transfer in brachial plexus injury.

Can a Partially Injured Donor Nerve Restore Elbow Flexion in an Acute Brachial Plexus Injury in Rats?

2019 ◽  
Vol 144 (5) ◽  
pp. 1105-1114
Author(s):  
Tommy Nai-Jen Chang ◽  
Mark Shafarenko ◽  
Rachel Dadouch ◽  
Evelyn Ting-Hsuan Tang ◽  
Jennifer Zhang ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Elbow Flexion
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