{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T04:18:18Z","timestamp":1769919498635,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,10,19]],"date-time":"2005-10-19T00:00:00Z","timestamp":1129680000000},"content-version":"vor","delay-in-days":3944,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[1995,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The favourable treatment of post\u2010traumatic brachial plexus lesions based on our experience of 362 cases over a 12 year period is reported. Twenty\u2010five percent of the patients needed secondary operations. The spectrum of the latter consisted of arthrodesis, tenodesis, and musculotendinous transfer, including free neurovascular tissue transfer partially innervated by nerve transposition. Functionally, secondary tendon transfer can help to improve the effect of nerve repair techniques. To restore shoulder function the trapezius transfer (n = 22) has been used mainly; elbow flexion has been regained by pedicled latissimus dorsi translocation (n = 22), triceps\u2010to\u2010biceps transfer (n = 18), bipolar latissimus muscle transfer, and free neurovascular tissue transfer (n = 8). The Steindler flexorplasty was performed in four plexopathies, and finally a pedicled serratus muscle transfer was used. A unipolar latissimus dorsi transfer results in an ability to lift 10\u201315 kg, whilst the bipolar latissimus transfer and the triceps\u2010to\u2010biceps transfer produced a maximal strength of 5\u20138 kg. Epitrochlear flexor\u2010pronator mass transfer produced a strength of 2\u20135 kg, whereas free neurovascular latissimus dorsi transfer developed a maximal muscular strength of 2\u20134 kg in the unipolar variation and 1\u20132 kg for the bipolar LD. In 97 secondary procedures to the lower arm and hand the following secondary operations were indicated: in 29 cases of radial nerve palsy transfers according to Merle d'Aubigne, a further 21 wrist tenodeses and 8 wrist arthrodeses were performed. To restore median nerve function, coupling tendon transfer (n = 4) and free neurovascular gracilis transfer (n = 3) were selected. Ulnar nerve palsy was corrected by seven Zancolli procedures. To improve rotation, two pronation plasties were applied. For dynamic opponensplasty the superficial flexor of the ring finger was the primary choice (n = 8). Static fusions between the first and second metacarpal bones served as a static opponensplasty of the thumb ray. Motor\u2010driven orthoses should be reserved for boosting any voluntary muscle contraction or for frustrating cases in which restoration of useful pinch with the previously described surgical procedures is impossible. Improving the function of the formerly paralysed upper extremity in patients with a brachial plexus injury results in a greater independence in everyday activities and a superior psychological status. \u00a9 Wiley\u2010Liss, Inc. \u00a9 1995 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/micr.1920160112","type":"journal-article","created":{"date-parts":[[2007,3,4]],"date-time":"2007-03-04T23:11:40Z","timestamp":1173049900000},"page":"43-47","source":"Crossref","is-referenced-by-count":42,"title":["Secondary surgery following brachial plexus injuries"],"prefix":"10.1002","volume":"16","author":[{"given":"Alfred","family":"Berger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,10,19]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"376","article-title":"Ersatzoperationen bei irreparablen Verletzungen des Plexus brachialis","volume":"220","author":"Berger A","year":"1991","journal-title":"Hefte zur Unfallheilkunde"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199101000-00011"},{"key":"e_1_2_1_4_2","first-page":"126","volume-title":"The Hand","author":"Ross A","year":"1991"},{"key":"e_1_2_1_5_2","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1302\/0301-620X.72B4.2380231","article-title":"Transfer of the trapezius for flail shoulder after brachial plexus injury","volume":"72","author":"Aziz W","year":"1990","journal-title":"Journal of Bone and Joint Surgery"},{"key":"e_1_2_1_6_2","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.2106\/00004623-197355060-00014","article-title":"Latissimus dorsi transfer to restore elbow flexion","volume":"55","author":"Zancolli E","year":"1973","journal-title":"Journal of Bone and Joint Surgery"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006809"},{"key":"e_1_2_1_8_2","volume-title":"The Traumatic Deformities and Disabilities of the Upper Extremity","author":"Steindler A","year":"1946"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(10)80004-8"},{"key":"e_1_2_1_10_2","first-page":"1303","volume-title":"Operative Nerve Repair and Reconstruction","author":"Richards RR","year":"1992"},{"key":"e_1_2_1_11_2","first-page":"632","volume-title":"The Hand","author":"Merle M","year":"1991"},{"key":"e_1_2_1_12_2","first-page":"147","volume-title":"The Hand","author":"Tubiana","year":"1991"},{"key":"e_1_2_1_13_2","first-page":"592","article-title":"Musculo\u2010tendinous transfer of the hand and forearm","volume":"95","author":"Hovius SER","year":"1993","journal-title":"Clinical Neurology and Neurosurgery"},{"key":"e_1_2_1_14_2","volume-title":"Ersatzoperationen f\u00fcr Motorik und Sensibilit\u00fct der Hand","author":"Wintsch K","year":"1980"},{"key":"e_1_2_1_15_2","first-page":"51","article-title":"Pulley zur Verst\u00e4rkung einer Muskelersatzoperation \u00fcber zwei Gelenke bei Plexus brachialis\u2010L\u00e4sionen: Beschreibung der Operationstechnik","volume":"26","author":"Berger A","year":"1994","journal-title":"Handchirurgie, Mikro\u2010chirurgie, Plastische Chirurgie"},{"key":"e_1_2_1_16_2","first-page":"107","volume-title":"L\u00e4sionen des Plexus brachialis","author":"Berger A","year":"1985"},{"key":"e_1_2_1_17_2","unstructured":"Buck\u2010Gramcko D Nigst H (eds): Motorische Ersatzoperationen. Band 2: Hand und Unterarm. Stuttgart Hippokrates 1991."},{"key":"e_1_2_1_18_2","unstructured":"RudigierJ: Motorische Ersatzoperationen der oberen Extremit\u00e4t. Band 1: Schulterg\u00fcrtel Oberarm und Ellenbogen. Stuttgart Hippokrates 1991."}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmicr.1920160112","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.1920160112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T19:27:19Z","timestamp":1698348439000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.1920160112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,1]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1995,1]]}},"alternative-id":["10.1002\/micr.1920160112"],"URL":"https:\/\/doi.org\/10.1002\/micr.1920160112","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,1]]}}}