Artavazd B. Sahakyan
CENTER OF PLASTIC AND RECONSTRUCTIVE SURGERY & MICROSURGERY
Yerevan, Armenia
At present all the traditional methods concerning humeral joint reconstruction after brachial plexus birth injury, particularly operation on tendinous-muscular and capsule-ligamental apparatus are not effective. The suggested method of trapezoid muscle transposiotion on neurovascular peduncle from ipsilateral side into deltoid position provided increased volume of humeral joint motility, as well as certain elimination of interior-rotational contracture.
The essence of the operation is the following: they cut off muscles from the clavicle, acromioclavicular joint, the upper part was separated from cervical vertebra. The muscle was cut along its length and the tendinous part was separated from the scapular crest. Mobilization of the transplant was done by optic magnification with precise skeletization of transversal artery and accessory nerve included in the muscular transplant. The length of this flap is sufficient for the possibility to attach both to the "punctum mobile" and "punctum fixum" of deltoid muscle.
We suggest this operation to be performed in patients with Mallet I-II-III, which, in our opinion, increases the efficiency of the operation and significantly increases hand functional capabilities.