Treatment Outcomes Of Elbow Flexion Reconstruction Of Oberlin Operation In The Treatment Of Brachial Plexus Upper Root Avulsion

Objective To study treatment outcome of elbow flexion reconstruction of Oberlin operation(end to side neuroanastomosis of musculocunatenous nerve-bicep's branch to ulnar nerve)in the treatment of brachial plexus upper root avulsion and its long term result.Methods From Jan 2004 to July 2016,72 patients with brachial plexus upper root avulsion have received Oberlin operation(end to side neuroanastomosis of musculocunatenous nerve-bicep's branch to ulnar nerve),50 male and 22 female,35 cases on the left side and 37 on the right.An average age of 34 years(8-52 years),time from injury to operation were 3-9 month,an average of 5.5 month,an average of follow up were 3 years and 7 month.All patients were diagnosed with brachial plexus upper root avulsion by comprehensive physical examination,electromyocardiogram and cervical MRI(make sure muscle strength innervated by ulnar nerve were ? M 4).Among 72 patients,55 were C5-C6 root avulsion and 17 were C5-C7 root avulsion.Elbow flexion function and Bicep muscle's strength were measured after operation(muscle's strength was measured by British Medical Research Council score system M0-M5).Muscle's strength recovery was considered as poor if <M3 and it was considered as good if ?M3.Results In 72 cases,62 were successfully followed up(86.11%),7 patients were lost of follow up(9.72%)and 3 patient didn't receive operation due to ulnar nerve anomaly(4.17%).62 patients were measured bicep's muscle strength at last follow up,among them there were 25 patients recovered muscle strength ?M4(41.0%),28 patients recovered muscle strength between M2-M3(44.2%)and 9 patients recovered muscle strength <M2(14.8%).Conclusion Oberlin operation is an effective operation in the treatment of brachial plexus upper root avulsion,one thing noted in this operation is that biggest bicepbranch of musculocutaneous nerve need to be selected and neuroanastomosis with ulnar nerve,otherwise post-operative ineffective bicep movement may occur.