Results in brachial plexus palsy after biceps neuro-muscular neurotization associated with neuro-neural neurotization and teno-muscular transfer.
None of the currently used techniques for elbow flexion recovery in brachial plexus recovery offers enough strength for normal life activities. The association between several methods grants a better result by a summarizing effect compared to each method used separately. The paper reveals the improvement of the functional results in brachial plexus reconstruction by combining the techniques of nerve repair (nerve grafts, nerve transfers or direct muscular neurotization) with palliative muscular transfers. Of the 54 cases of microsurgical reconstruction of brachial plexus palsy, in 20 cases we associated a muscular transposition: 7 latissimus dorsi transfers (5 monopolar and 2 bipolar), 5 pectoralis major and 8 triceps transfers. The direct neuro-muscular neurotization of the biceps-EMG efficient - was associated with a muscular transfer in 8 cases: in 4 of the 7 latissimus dorsi transfers, in 3 cases of triceps transfer and in 2 case of pectoralis major transfer. The association of the 3 methods - direct neuromuscular neurotization, neuro-neuronal neurotization and muscular transfer - has a summarizing effect in the flexion restoration of the elbow flexion, which represents a major problem in the brachial plexus palsy.