Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury.
Reoperation rate
ndication
rachial plexus injury
ree functional muscle transfers
Journal
The archives of bone and joint surgery
ISSN: 2345-4644
Titre abrégé: Arch Bone Jt Surg
Pays: Iran
ID NLM: 101636743
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
entrez:
9
8
2020
pubmed:
9
8
2020
medline:
9
8
2020
Statut:
ppublish
Résumé
Free functional gracilis muscle transfers (FFGT) are an option for reconstruction after traumatic brachial plexus injury. Few studies report the rate of revision surgeries following free functional muscle transfers. We examined the reoperation rate and indication for reoperation after primary reconstruction of upper extremity function with a free gracilis transfer after brachial plexus injury. From 2003-2016, we identified 25 patients who underwent a free functional gracilis muscle transfer for restoration of upper extremity function. We reviewed their medical charts to record patient, injury, and treatment characteristics. Indication for reoperation and reoperative procedure were also identified. Fourteen out of 25 patients (56%) had a reoperation after FFGT. Four flaps were re-explored for vascular compromise, but there were no flap failures. The majority of reoperations involved adjustment of tendon excursion (8/14) which demonstrated that tenolysis was the main procedure. Despite promising results of free functional gracilis transfers, reoperation is relatively common and should be discussed with the patient as a preoperative strategy. Early exploration of vascular compromise may decrease the flap failure. Poor tendon excursion is a common unpredicted consequence after FFMT and is the main indication for reoperation.
Sections du résumé
BACKGROUND
BACKGROUND
Free functional gracilis muscle transfers (FFGT) are an option for reconstruction after traumatic brachial plexus injury. Few studies report the rate of revision surgeries following free functional muscle transfers. We examined the reoperation rate and indication for reoperation after primary reconstruction of upper extremity function with a free gracilis transfer after brachial plexus injury.
METHODS
METHODS
From 2003-2016, we identified 25 patients who underwent a free functional gracilis muscle transfer for restoration of upper extremity function. We reviewed their medical charts to record patient, injury, and treatment characteristics. Indication for reoperation and reoperative procedure were also identified.
RESULTS
RESULTS
Fourteen out of 25 patients (56%) had a reoperation after FFGT. Four flaps were re-explored for vascular compromise, but there were no flap failures. The majority of reoperations involved adjustment of tendon excursion (8/14) which demonstrated that tenolysis was the main procedure.
CONCLUSION
CONCLUSIONS
Despite promising results of free functional gracilis transfers, reoperation is relatively common and should be discussed with the patient as a preoperative strategy. Early exploration of vascular compromise may decrease the flap failure. Poor tendon excursion is a common unpredicted consequence after FFMT and is the main indication for reoperation.
Identifiants
pubmed: 32766394
doi: 10.22038/abjs.2019.41123.2113
pmc: PMC7358244
doi:
Types de publication
Journal Article
Langues
eng
Pagination
368-372Références
Plast Reconstr Surg. 1993 Apr;91(5):872-83
pubmed: 8460191
Acta Orthop Belg. 2009 Feb;75(1):8-13
pubmed: 19358391
J Plast Reconstr Aesthet Surg. 2016 Mar;69(3):311-7
pubmed: 26776904
Plast Surg (Oakv). 2014 Spring;22(1):26-9
pubmed: 25152644
J Hand Surg Am. 2012 Dec;37(12):2557-63.e1
pubmed: 23174070
Neurosurg Focus. 2004 May 15;16(5):E8
pubmed: 15174828
J Plast Reconstr Aesthet Surg. 2008 Jul;61(7):772-6
pubmed: 18248863
J Bone Joint Surg Am. 2006 Sep;88(9):1944-51
pubmed: 16951109
J Plast Reconstr Aesthet Surg. 2010 Jul;63(7):1142-9
pubmed: 19525160
Singapore Med J. 2007 Jul;48(7):652-5
pubmed: 17609828
Plast Reconstr Surg. 1991 Jun;87(6):1074-9
pubmed: 2034727
Neurosurg Clin N Am. 2009 Jan;20(1):51-64, vi
pubmed: 19064179
J Bone Joint Surg Am. 2000 May;82(5):652-66
pubmed: 10819276
Injury. 2008 Sep;39 Suppl 3:S15-22
pubmed: 18687429
Hand (N Y). 2010 Jun;5(2):160-70
pubmed: 19806408
J Hand Surg Am. 1996 Nov;21(6):1071-7
pubmed: 8969434
Plast Reconstr Surg. 2008 Jun;121(6):2037-45
pubmed: 18520894
Orthop Traumatol Surg Res. 2011 Dec;97(8):785-92
pubmed: 22112464
Sci Rep. 2016 Mar 03;6:22479
pubmed: 26935173
Plast Reconstr Surg. 2009 Dec;124(6):2027-39
pubmed: 19952659
Injury. 2016 Nov;47(11):2525-2533
pubmed: 27594169
Hand Clin. 2016 Aug;32(3):311-21
pubmed: 27387075
Plast Reconstr Surg. 2007 Jun;119(7):2092-100
pubmed: 17519706
Clin Orthop Relat Res. 1995 May;(314):104-11
pubmed: 7634622
Bone Joint J. 2016 Feb;98-B(2):209-17
pubmed: 26850426