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Khirurgii

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Year 2011 Vol. 19 No 5

NEUROSURGERY

A.F. SMEYANOVICH, R.R. SIDOROVICH, А.Е. BARANOVSKY, I.A. SEMAK, O.A. YUDINA

TRAPEZOIDAL MUSCLE TRANSPOSITION METHOD IN REHABILITATION OF PATIENTS WITH BRACHIAL PLEXUS TRAUMATIC DAMAGE OUTCOMES

Objectives. To work out the method of trapezoidal muscle transposition on the front shoulder surface to restore active forearm flexion on the basis of peculiarities studying of its innervation and blood supply.
Methods. Anatomic and topographic study was carried out on 20 anatomic preparations; peculiarities of topography, innervations and blood supply of the trapezoidal muscle were investigated. The method of monopolar transposition of the upper triangle flap of the trapezoidal muscle on the front surface of the upper third of the shoulder with fixation to the proximal part of the paralyzed shoulder bicipital muscle was worked out on the basis of the anatomical and topographic study. Operative intervention with the application of the given method was carried out in 16 patients with the brachial plexus traumatic damage outcomes.
Results. In the first 3-6 months after the operation restoration of the forearm active flexion volume from 60 up to 90° and muscular strength up to M3 (a satisfactory result) was noted in 5 operated patients (31,3%), a negative result of restoration of volume and strength of the forearm active flexion was marked in 11 patients (68,7%). In terms longer than 6 months (10,3±1,3 months) in 6 patients (37,5%) the volume of the forearm active flexion restored up to the angle of 60-90°,muscular strength of flexion up to 3 points (satisfactory result). Negative result was registered in 10 patients (62,5%).
Conclusions. This method can be applied to restore the forearm active flexion in case of other transpositioned muscles denervation; its efficacy made up 37,5%.

Keywords: trapezoidal muscle, brachial plexus trauma, trapezoidal muscle transposition
p. 90 – 95 of the original issue
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