استفاده از انتقال آزاد عضله گراسيليس براي برقراري ابداكشن و فلكشن به جلوي شانه در ضايعات شبكه بازويي

Functioning free Gracilis transplantation for restoration of shoulder abduction and forward flexion in brachial plexus injury

Background: Loss of active abduction and forward flexion of shoulder in brachial plexus injury (BPI) is a severe disability in daily life and employment. Several methods of tendon transfer, such as Saha, Hartman and Bateman procedure, have been described with a limited function. In this study, 4 cases treated with functioning free Gracilis muscle transplantation for BPI were reported. Methods: In this clinical trial, four patients with upper roots of brachial plexus injury treated with functioning free Gracilis muscle transplantation were studied. Patients lower than 40 years and without vascular injury or limitation of shoulder were enrolled in the study. After muscle transplantation, patients had splint for 3 weeks. They received physiotherapy for 4 weeks, and then were followed up to evaluate failure of surgery and active abduction and forward flexion of shoulder for one year. Results: 4 patients with mean age of 31 years were studied. All of them were male. Time to first contraction was 3.4±0.8 months. The mean shoulder abduction and forward flexion due to free Gracilis muscle transplantation was 90°±14° and about 90°, respectively. Conclusion: It seems that functioning free Gracilis muscle transplantation has satisfactory results on increasing shoulder abduction and forward flexion.