Free functioning gracilis transfer for reanimation of elbow and hand in total traumatic brachial plexopathy in children
The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (rang...
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| Published in: | The Journal of hand surgery, European volume Vol. 43; no. 6; pp. 596 - 608 |
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| Abstract | The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3–17) who were followed-up over a mean period of 6 years (range 2–16). The transferred gracilis delivered a stable elbow flexion with a useful power, as well as reconstructed active finger motion. In 3–11-year-old patients we noted a tendency towards developing a progressive flexion contracture of the elbow. The limb length discrepancy observed in our patients was not different from the brachial plexus palsy patients treated without the free functioning gracilis transfer. In conclusion, the free functioning gracilis transfer is a reliable reconstructive technique for reanimating upper extremity in children of all ages capable of delivering stable function over a long period of time.
Level of evidence: IV |
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| AbstractList | The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3-17) who were followed-up over a mean period of 6 years (range 2-16). The transferred gracilis delivered a stable elbow flexion with a useful power, as well as reconstructed active finger motion. In 3-11-year-old patients we noted a tendency towards developing a progressive flexion contracture of the elbow. The limb length discrepancy observed in our patients was not different from the brachial plexus palsy patients treated without the free functioning gracilis transfer. In conclusion, the free functioning gracilis transfer is a reliable reconstructive technique for reanimating upper extremity in children of all ages capable of delivering stable function over a long period of time. LEVEL OF EVIDENCEIV. The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3-17) who were followed-up over a mean period of 6 years (range 2-16). The transferred gracilis delivered a stable elbow flexion with a useful power, as well as reconstructed active finger motion. In 3-11-year-old patients we noted a tendency towards developing a progressive flexion contracture of the elbow. The limb length discrepancy observed in our patients was not different from the brachial plexus palsy patients treated without the free functioning gracilis transfer. In conclusion, the free functioning gracilis transfer is a reliable reconstructive technique for reanimating upper extremity in children of all ages capable of delivering stable function over a long period of time. IV. The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3–17) who were followed-up over a mean period of 6 years (range 2–16). The transferred gracilis delivered a stable elbow flexion with a useful power, as well as reconstructed active finger motion. In 3–11-year-old patients we noted a tendency towards developing a progressive flexion contracture of the elbow. The limb length discrepancy observed in our patients was not different from the brachial plexus palsy patients treated without the free functioning gracilis transfer. In conclusion, the free functioning gracilis transfer is a reliable reconstructive technique for reanimating upper extremity in children of all ages capable of delivering stable function over a long period of time. Level of evidence: IV |
| Author | Hattori, Yasunori Shimoe, Takashi Doi, Kazuteru Sakamoto, Sotetsu Madura, Tomas |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29547071$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1080/03014469300002502 10.2106/JBJS.J.01744 10.3171/foc.2004.16.5.9 10.1002/micr.22373 10.1016/j.jhsa.2013.03.041 10.1097/PRS.0b013e318262f26b 10.1097/PRS.0b013e3181706f3c 10.1186/1471-2474-15-116 10.1054/JHSB.2002.0831 10.1002/ajhb.20077 10.1177/1753193408090140 10.2106/JBJS.J.01846 10.1007/s11552-010-9270-z 10.2106/JBJS.K.01279 10.1177/088307389400900220 10.1002/ajhb.20441 10.2106/JBJS.ST.M.00010 10.1016/j.arcped.2008.10.010 10.1016/j.jhsa.2009.09.014 10.1016/j.bjps.2009.05.021 10.1016/j.jhsa.2014.06.020 |
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| References | Ballinger, Hoffer 1994; 9 Doi, Arakawa, Hattori, Baliarsing 2011; 93 Fischer, Elliott, Kozin, Levin 2013; 38 Al-Qattan 2003; 28 Bain, DeMatteo, Gjertsen, Packham, Galea, Harper 2012; 130 Kay, Pinder, Wiper, Hart, Jones, Yates 2010; 63 Smith, Buschang 2004; 16 Doi 2008; 33 Ho, Roy, Stephens, Clarke 2010; 35 El-Gammal, El-Sayed, Kotb 2015; 35 Doi, Hattori, Yamazaki, Wahegaonkar, Addosooki, Watanabe 2008; 121 Terzis, Kokkalis 2010; 5 de Onis, Garza, Onyango, Rolland-Cachera 2009; 16 Satake, Kikuta, Ozaki 1993; 20 Dodakundi, Doi, Hattori 2013; 95 Smith, Buschang 2005; 17 Smith, Calfee, Baumgarten, Brophy, Wright 2012; 94 Barrie, Steinmann, Shin, Spinner, Bishop 2004; 16 Doi, Hattori, Sakamoto, Dodakundi, Satbhai, Montales 2013; 3 Chim, Kircher, Spinner, Bishop, Shin 2014; 39 Maresh 1955; 89 Gosk, Wnukiewicz, Urban 2014; 15 bibr2-1753193418762950 bibr13-1753193418762950 bibr9-1753193418762950 bibr21-1753193418762950 bibr18-1753193418762950 bibr22-1753193418762950 bibr15-1753193418762950 bibr6-1753193418762950 bibr11-1753193418762950 bibr4-1753193418762950 bibr8-1753193418762950 bibr20-1753193418762950 bibr14-1753193418762950 bibr19-1753193418762950 bibr5-1753193418762950 bibr16-1753193418762950 Maresh MM (bibr17-1753193418762950) 1955; 89 bibr1-1753193418762950 bibr7-1753193418762950 bibr12-1753193418762950 bibr3-1753193418762950 bibr10-1753193418762950 |
| References_xml | – volume: 35 start-page: 84 year: 2010 end-page: 91 article-title: Serial casting and splinting of elbow contractures in children with obstetric brachial plexus palsy publication-title: J Hand Surg Am contributor: fullname: Clarke – volume: 35 start-page: 350 year: 2015 end-page: 5 article-title: Free functioning gracilis transplantation for reconstruction of elbow and hand functions in late obstetric brachial plexus palsy publication-title: Microsurgery contributor: fullname: Kotb – volume: 3 start-page: e16 year: 2013 end-page: e16 article-title: Current procedure of double free muscle transfer for traumatic total brachial plexus palsy publication-title: JBJS Essent Surg Tech contributor: fullname: Montales – volume: 95 start-page: 1505 year: 2013 end-page: 12 article-title: Outcome of surgical reconstruction after traumatic total brachial plexus palsy publication-title: J Bone Joint Surg Am contributor: fullname: Hattori – volume: 38 start-page: 2485 year: 2013 end-page: 90 article-title: Free function muscle transfers for upper extremity reconstruction: a review of indications, techniques, and outcomes publication-title: J Hand Surg Am contributor: fullname: Levin – volume: 20 start-page: 67 year: 1993 end-page: 70 article-title: Ages at peak velocity and peak velocities for seven body dimensions in Japanese children publication-title: Ann Hum Biol contributor: fullname: Ozaki – volume: 16 start-page: 648 year: 2004 end-page: 57 article-title: Variation in longitudinal diaphyseal long bone growth in children three to ten years of age publication-title: Am J Hum Biol contributor: fullname: Buschang – volume: 28 start-page: 46 year: 2003 end-page: 9 article-title: Assessment of the motor power in older children with obstetric brachial plexus palsy publication-title: J Hand Surg Br contributor: fullname: Al-Qattan – volume: 15 start-page: 116 year: 2014 article-title: The effect of perinatal brachial plexus lesion on upper limb development publication-title: BMC Musculoskelet Disord contributor: fullname: Urban – volume: 94 start-page: 277 year: 2012 end-page: 85 article-title: Upper extremity-specific measures of disability and outcomes in orthopaedic surgery publication-title: J Bone Joint Surg Am contributor: fullname: Wright – volume: 130 year: 2012 article-title: Limb length differences after obstetrical brachial plexus injury: a growing concern publication-title: Plast Reconstr Surg contributor: fullname: Harper – volume: 9 start-page: 209 year: 1994 end-page: 10 article-title: Elbow flexion contracture in Erb’s palsy publication-title: J Child Neurol contributor: fullname: Hoffer – volume: 16 start-page: E8 year: 2004 article-title: Gracilis free muscle transfer for restoration of function after complete brachial plexus avulsion publication-title: Neurosurg Focus contributor: fullname: Bishop – volume: 63 start-page: 1142 year: 2010 end-page: 9 article-title: Microvascular free functioning gracilis transfer with nerve transfer to establish elbow flexion publication-title: J Plast Reconstr Aesthetic Surg contributor: fullname: Yates – volume: 33 start-page: 240 year: 2008 end-page: 51 article-title: Management of total paralysis of the brachial plexus by the double free-muscle transfer technique publication-title: J Hand Surg Eur contributor: fullname: Doi – volume: 16 start-page: 47 year: 2009 end-page: 53 article-title: WHO growth standards for infants and young children publication-title: Arch Pédiatrie Organe Off Sociéte Fr Pédiatrie contributor: fullname: Rolland-Cachera – volume: 93 start-page: e105 year: 2011 article-title: Restoration of elbow flexion with functioning free muscle transfer in arthrogryposis: a report of two cases publication-title: J Bone Joint Surg Am contributor: fullname: Baliarsing – volume: 5 start-page: 386 year: 2010 end-page: 96 article-title: Bone discrepancy as a powerful indicator for early surgery in obstetric brachial plexus palsy publication-title: Hand NYN contributor: fullname: Kokkalis – volume: 89 start-page: 725 year: 1955 end-page: 42 article-title: Linear growth of long bones of extremities from infancy through adolescence; 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