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Atthakomol, Pichitchai, Ozkan, Sezai, Eberlin, Kyle R., Chen, Neal, Winograd, Jonathan, Lee, Sang-Gil. (1399). Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury. , 8(3), 368-372. doi: 10.22038/abjs.2019.41123.2113
Pichitchai Atthakomol; Sezai Ozkan; Kyle R. Eberlin; Neal Chen; Jonathan Winograd; Sang-Gil Lee. "Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury". , 8, 3, 1399, 368-372. doi: 10.22038/abjs.2019.41123.2113
Atthakomol, Pichitchai, Ozkan, Sezai, Eberlin, Kyle R., Chen, Neal, Winograd, Jonathan, Lee, Sang-Gil. (1399). 'Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury', , 8(3), pp. 368-372. doi: 10.22038/abjs.2019.41123.2113
Atthakomol, Pichitchai, Ozkan, Sezai, Eberlin, Kyle R., Chen, Neal, Winograd, Jonathan, Lee, Sang-Gil. Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury. , 1399; 8(3): 368-372. doi: 10.22038/abjs.2019.41123.2113

Reoperation Rate and Indication for Reoperation after Free Functional Muscle Transfers in Traumatic Brachial Plexus Injury

The Archives of Bone and Joint Surgery
دوره 8، شماره 3، مرداد 2020، صفحه 368-372    اصل مقاله (383.64 K)
نوع مقاله: RESEARCH PAPER
شناسه دیجیتال (DOI): 10.22038/abjs.2019.41123.2113
نویسندگان
Pichitchai Atthakomol* 1؛ Sezai Ozkan2؛ Kyle R. Eberlin3؛ Neal Chen4؛ Jonathan Winograd3؛ Sang-Gil Lee2
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Thailand
2Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
3Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Boston, MA, USA
4Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School
چکیده
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: 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: 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: 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.
Level of evidence: IV
کلیدواژه‌ها
Brachial plexus injury؛ Free functional muscle transfers؛ Indication؛ Reoperation rate
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