We performed 2 prospective studies to evaluate clinical results of triple FFMT and CC7 combined FFMT for total arm type BPI reconstruction.
From 2001 to 2010, 85 patients received the 1st stage free gracilis-adductor DFFMT and the 2nd stage single graculis FFMT; so called “triple flaps FFMT”; for complete total avulsion BPI. The 1st DFFMT was serving as elbow flexor and wrist/finger extensor, while the second gracilis FFMT was serving as finger flexor in the 2nd stage surgery. The average follow-up was 7.5 years. We obtained 90% M4 elbow function and M4 wrist/finger extension, and 70% M4 handgrip in 3 years F/U.
In another study, we analyzed the BPI patients receiving contra-lateral C7 nerves neurotization on median nerve for total arm type BPI (as the 1st stage surgery), and a secondary stage surgery, a gracilis FFMT was transferred for finger flexion 1.5 years after the 1st stage C7 transfer. The previous transferred C7 was serving as neurotizer of this FFMT. We had 32 patients (80%) achieved at least M3 hand and finger flexion. Twenty-eight patients (70%) with M4 hand and finger flexion. Elbow flexion M4: (85%); sensory recovery: (80%).
We concluded that triple FFMT and CC7 combined FFMT are worthwhile methods for BPI reconstruction.Le texte complet de cet article est disponible en PDF.