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Table 3 Characteristics of secondary surgery

From: Obesity status is a risk factor for secondary surgery after neurolysis, direct nerve repair or nerve grafting in traumatic brachial plexus injury: a retrospective cohort study

Patient

Primary surgery

Recovery after primary operation

Indication for secondary surgery

Time between initial injury to secondary surgery (months)

Secondary surgery

Third surgery

Fourth surgery

1

Nerve grafting median nerve

No

No recovery of index and thumb flexion

18.3

-Tenodesis FDP Ring, little to others

  

2

Nerve grafting at trunk level

No

No recovery of wrist extension

17.5

-Tendon transfer PT to ECRB

Tendon transfer for finger and thumb extension

 

3

Neurolysis

Partial

Minimal recovery of wrist extension, finger and thumb extension (not function)

24.9

Tendon transfer PL to EPL, FCR to ECRB and FCU to EDC

Tenodesis FDP little to others for finger flexion, FDS index tendon transfer fo thumb extension, wrist fusion for finger motion

 

4

Neurolysis

No

No recovery of elbow flexion

41.8

-Latissimus dorsi transfer to distal biceps tendon

  

5

Neurolysis

Partial

Recovery of shoulder abduction but no recovery of shoulder external rotation

30.8

-Latissimus dorsi transfer to infraspinatus insertion

Reattachment Latissimus dorsi insertion (loosening over time)

Reattachment Latissimus dorsi insertion (loosening over time)

6

Neurolysis

Partial

Minimal rocovery of shoulder abduction

46.1

Muscle transfer to restore shoulder abduction

  

7

Neurolysis

Partial

Mininal recovery of elbow flexion (not function)

24.8

-Free functional gracilis muscle transfer to distal biceps

Latissimus dorsi transfer for elbow flexion

 

8

Neurolysis

Partial

Minimal rocovery of shoulder abduction

48.3

Shoulder arthrodesis

  

9

Nerve grafting from fifth cervical root to suprascapular nerve and anterior division of upper trunk

Partial

Mininal recovery of shoulder abduction (not function)

28.6

-Transhumeral amputation

Shoulder disarticulation

 
  1. Time from primary operation to reoperation, median (IQR), m: 12 [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23]
  2. FDP Flexor Digitorum Profundus, PT Pronator Teres, ECRB Extensor Carpi Radialis Brevis, PL Palmaris Longus, EPL Extensor Pollicis Longus, FCR Flexor Carpi Radialis, FCU Flexor Carpi Ulnaris, EDC Extensor Digitorum Superficialis, FDS Flexor Digitorum Superficialis