[Functional reconstruction of irreversible partial injury of brachial plexus].

OBJECTIVE

To assess treating results of functional reconstruction of irreversible partial injury of brachial plexus and to improve the function of injured upper extremity.

METHODS

Seventy-nine cases with irreversible partial injury of brachial plexus were treated in transfer of muscle (tendon) or by functional arthrodesis (fixation of tendon) from January 1984 to June 2003. According to the evaluation criterion by American Shoulder and Elbow, Hand Association, all patients were followed up in motion of reconstructive joint and daily activities after operation for 1 year to 19 years. The effect of the operation was comprehensively scored and evaluated.

RESULTS

Final results in 54 cases were as follows: 30 patients with good results, 19 patients with fair results, and 5 with poor results. The results demonstrated some points as follow: (1) if the shoulder was instable, arthrodesis of shoulder would be a better choice; (2) the flexion of the elbow joint should be only reconstructed with the dynamic reconstructive methods. The reconstruction of flexion of elbow by transfer of pectoral major muscle was more effective than that by transfer of flexor carpi ulnaris muscle; (3) the dynamic reconstruction of extension of digital and carpi was better than that of flexion of digital and opposition function of the thumb; (4) the supination of the forearm was effectively reconstructed by transfer of flexor carpi ulnaris muscle. Pronation teres muscle should be studied more in reconstruction of supination function of the forearm.

CONCLUSION

The functional reconstruction is effective in treating irreversible partial injury of brachial plexus.