Trapezius Muscle Transfer for Restoration of Elbow Extension in a Traumatic Brachial Plexus Injury

Description

In this surgical video, Dr. Janet Conway performs a trapezius muscle transfer to enhance elbow extension for a patient suffering from brachial plexus palsy. The procedure begins with an incision extending from the third lumbar vertebra to the medial proximal border of the scapula. The trapezius muscle's medial border is isolated and elevated, with careful stripping of fascia to attach it securely to the elbow, specifically to the triceps fascia.



Throughout the surgery, there is a focus on ensuring adequate length and securing sufficient vascular supply to the trapezius. The dissection process involves careful separation of the trapezius from the underlying rhomboids and ensuring enough fascia is harvested for the transfer. The surgical team meticulously prepares the tissue and assesses the elbow to ensure the transferred tissue will be adequately tensioned and functional post-surgery.



As the procedure progresses, additional steps include tunneling the fascia from the trapezius to the elbow incision, where it will be sutured into the triceps tendon. The video captures the intricacies involved in maintaining vascular integrity, ensuring no tension on the pedicles, and confirming that the transferred muscle has expected tension and excursion. Finally, the operation concludes with securing the surgical site and preparing for the patient's recovery.

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