Evaluation of elbow function following bipolar latissimus dorsi flap in late partial brachial plexus injury: A case report

• Published in: International journal of surgery open 2019, Vol.18, p.18-21
• Main Authors: Saleh, Ruksal, Paturusi, Idrus, Sakti, Muhammad, Pasallo, Padlan, Maulidiah, Qariah, Guatama, Astrawinata
• Format: Article
• Language: English
• Subjects: Bipolar latissimus dorsi flap; Brachial plexus injury; Elbow reanimation
• ISSN: 2405-8572; 2405-8572
• DOI: 10.1016/j.ijso.2019.05.002

The goals of the treatment of brachial plexus palsies or traumatic loss of upper extremity function are including hand reanimation, protective hand sensation, shoulder stability, and elbow function as the first priority in upper extremity reconstruction. One method that has been developed to solve this problem is bipolar transfer of the latissimus dorsi muscle. We present a case of 37-years-old male with late case of partial brachial plexus injury treated with bipolar latissimus dorsi flap. Aim for this research is to report a long term satisfying elbow and shoulder clinical function outcome after performed bipolar latissimus dorsi muscle transfer. Seven years post-surgical follow up showed active shoulder abduction at 180°, active shoulder external rotation at 45°, active shoulder forward flexion at 90°, extend shoulder until 20°, active elbow flexion at 120°, active elbow extension until 0°. Elbow flexion strength was measured using the MRC grading system-with elbow flexed at 90o-was M5. We concluded that bipolar latissimus dorsi muscle flap provides a good outcome in elbow reanimation following late brachial plexus injury. Preoperative donor muscle strength evaluation will predict satisfactory postoperative result. •Bipolar transfer of latissimus dorsi muscle is a good treatment plan for late brachial plexus injury.•Treatment series include surgery and post-surgical care.•Functional range of motion is obtained using this method.•Long term monitoring satisfy both patient and surgeon.