Study of epidemiology and nerve transfer surgeries for elbow flexion in upper brachial plexus injuries–A five year review

Introduction

Traumatic brachial plexus palsy is one of the commonest disability among the survivors of road traffic accidents.Though nerve transfers for elbow reanimation are unpredictable in  in pan brachial plexus palsy, Oberlin’s procedure of transferring an intact ulnar nerve fascicle revolutionize the scope for recovery of elbow flexion in upper brachial plexus injuries.

Materials and methods

This is a retrospective study of patients with upper brachial plexus palsy who were operated for elbow neurotization in our centre from January 2012 to December 2016.Out of the 42 patients who underwent the elbow neurotization procedures for upper brachial plexus injury, only 24 patients responded to our call. Hence, epidemiological data are available for 42 patients but evaluation studies are possible in only 24 patients.

Results

The age of the patients ranged from 15 years to 50 years.In 30 patients the right side was affected and in 12 patients the left side was affected.50% of the patients sustained associated head injury. Only in 8% of patients there was no associated injury.In Oberlin transfer 60% of patients achieved a power of Gr IV. 20%  obtained a power of Gr III.In 20% of patients no useful flexion could be achieved.

Conclusion

In upper brachial plexus injuries Oberlin 1 transfer if done at the earliest possible time, offers the best hope for the recovery of elbow flexion.