title: Objective evaluation of elbow flexion strength and fatigability after nerve transfer in adult traumatic upper brachial plexus injuries.
abstract: Nerve transfers Oberlin-type are currently used in upper brachial plexus lesions to recover elbow flexion. Is the regained active motion sufficient to resume heavy manual activities? Five adult patients (mean age 37 years) operated of a nerve transfer to recover elbow flexion (transfer of a motor fascicle of the ulnar nerve to the motor branch of the biceps; in three patients, additional transfer from the median to the motor nerve of the brachialis) were clinically and isokinetically evaluated, after a mean follow-up of 47 months. The median Constant-Murley score was 22/100, the DASH 56/100 and the MEPI 60/100. For isokinetic tests the most significant finding was a severe deficit of elbow strength, of about 80%. No patient was able to maintain an isometric contraction during sufficient time to evaluate fatigability. This preliminary study suggests that major functional impairments persist despite early recovery of elbow flexion. These results should be confirmed in a study on a larger group of patients.
authors.affiliation: Haute Ecole Libre de Bruxelles - Ilya Prigogine, Belgium.
authors.forename: Céline
authors.initials: C
authors.lastname: Maricq
authors.forename: Martine
authors.initials: M
authors.lastname: Jeunehomme
authors.forename: Dominique
authors.initials: D
authors.lastname: Mouraux
authors.forename: Pascal
authors.initials: P
authors.lastname: Rémy
authors.forename: Eric
authors.initials: E
authors.lastname: Brassinne
authors.forename: Jörg
authors.initials: J
authors.lastname: Bahm
authors.forename: Frédéric
authors.initials: F
authors.lastname: Schuind
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D004551:Elbow Joint / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000601:surgery*; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology; D016067:Nerve Transfer; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000601:surgery*; D055815:Young Adult
keywords: Brachial Plexus; Elbow Flexion; Fatigability; Isokinetic Testing; Nerve Transfer; Neurotization; Oberlin Procedure