05/18/2026
Nine months after muscle transfer surgery, and this young man can bend his arm again! It is always the best feeling seeing patients recover motion after brachial plexus injury. This patient was lucky, and his injury did not affect his hand. This gave us more options for reconstruction of his elbow motion. To treat this patient, we borrowed an extra muscle from the inside of the thigh and transplanted it to his arm (lucky for us, we have a few muscles that are extra and can be used for this job). We connected the muscle to nerves in the arm that normally control a muscle that bend the wrist (lucky for us, we also have a few muscles that do this job also, and can spare one for this goal!) We also attached the muscle to blood vessels in the arm, and to the collar bone and biceps, so that as it recovered, it would bend the elbow. For those in the know, this was a delayed presentation upper plexus injury, and we were past the window of nerve transfers. We did a reverse gracilis, with the tendon at the clavicle and the muscle belly tubularized at the biceps tendon. The donor motor was the FCU branch of the ulnar nerve. has published a report like this combined with a Steindler flexorplasty, but we did not feel we needed that added step.