{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:16:24Z","timestamp":1790806584001,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T00:00:00Z","timestamp":1548115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Elbow flexion deficit is a frequent problem in traumatic brachial plexus injuries and reestablishment of this function is the primary treatment goal. When management is delayed, or the initial acute approach fails, free functional transfer of the gracilis muscle for elbow flexion is the treatment of choice. In this report, the authors present the results of a comparison study on different donor nerves (spinal accessory and ulnar) in elbow flexion reconstruction with gracilis flap for traumatic adult brachial plexus injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of patients with both total or partial traumatic brachial plexus injuries was carried out. Of the 38 patients enrolled, 37 were male (97.4%) with a mean age of 28.3 years. The mean follow\u2010up period was 25\u2009months. Postoperative function of the gracilis muscle flap was recorded and patients were divided into two groups according to donor nerve: spinal accessory nerve (SAN) (18 cases), and motor fascicles of the ulnar (ULNAR) (20 cases).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010six cases obtained elbow flexion strength M3 or M4 (68.4%): 0\u2009M0 (0.0%), 4\u2009M1 (10.5%), 8\u2009M2 (21.1%), 9\u2009M3 (23.7%) and 17\u2009M4 (44.7%). The mean interval to first recorded M3 muscular strength was 12.4\u2009months. Functional elbow flexion strength (\u2265 M3) had the following distribution: SAN 83.3% (15\/18) and ULNAR 55.0% (11\/20) (<jats:italic>p<\/jats:italic> =\u2009.086).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No statistical difference for final muscle strength was found between donor nerve groups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30426","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T07:42:34Z","timestamp":1548315754000},"page":"400-404","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison between donor nerves to motorize the free functional gracilis muscle transfer for elbow flexion: Retrospective study of 38 consecutive cases in traumatic adult brachial plexus injuries"],"prefix":"10.1002","volume":"39","author":[{"given":"Alvaro B.","family":"Cho","sequence":"first","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8684-4479","authenticated-orcid":false,"given":"Gustavo","family":"Bersani Silva","sequence":"additional","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina J.","family":"Pisani","sequence":"additional","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jairo A.","family":"Alves","sequence":"additional","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-5147","authenticated-orcid":false,"given":"Raquel B.","family":"Iamaguchi","sequence":"additional","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teng H.","family":"Wei","sequence":"additional","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo R.","family":"de Rezende","sequence":"additional","affiliation":[{"name":"Hand and Microsurgery Unit, Department of Orthopaedic Surgery S\u00e3o Paulo University  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,22]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Implica\u00e7\u00f5es sociais e econ\u00f4micas nos pacientes v\u00edtimas de acidentes com motocicleta internados no IOT\u2010HCFMUSP [disserta\u00e7\u00e3o]","author":"Anjos K. 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