Our Experience of Bipolar Latissmus Dorsi Transfer for Elbow Flexion in Brachial Plexus Injuries

Abstract Objective: Upper extremity functional reconstruction after brachial plexus injury is a challenging task for a reconstructive surgeon. Patients experiencing brachial plexus injuries bare wearisome economical and social burden. A number of reconstructive options are described for restoration of elbow flexion. We aim to share our experience of elbow flexion reconstruction with pedicled bipolar Latissimus dorsi flap at single plastic and reconstructive surgery center. Methods: During the time period of 4 years i.e., January 2019 to December 2022, 12 patients underwent elbow flexion reconstruction with bipolar latissimus dorsi flap after brachial plexus injuries. All procedures were planned and performed after serial clinical examinations and EMG-NCS studies. Post operatively patients were followed for routine checkup and physiotherapy. Results: Among the patients undergoing elbow flexion reconstruction, 11 patients were male and one female patient. Average age was 25.66 (range 5-50 years). Average time elapsed since the time of injury was 12 months in adult population and 6.66 years in pediatric population. All patients gained MRC grade for elbow flexion (M4) and average range of elbow flexion was 120° degrees. Conclusion: Latissimus dorsi is a useful option for elbow flexion reconstruction. Excellent range of motion and MRC (medical research council) grades of muscle strength can be achieved. Keywords: Brachial plexus injury, Obstetric brachial plexus injury, elbow flexion, bipolar latissimus dorsi transfer.