trAnsferÊnciAs microcirÚrGicAs do mÚsculo GrÁcil pArA flexão do cotovelo nA lesão do plexo brAQuiAl do Adulto: estudo retrospectivo de oito cAsos microsUrgical transfer of the gracilis mUscle for elBow flexion in Brachial plexUs injUry in adUlts: retrospective stUdy of eight cases

Objective: Treating brachial plexus injuries is a major chal- lenge, especially lesions that are presented late, with more than 12 months of evolution. We retrospectively analyzed pa- tients who underwent one of the possibilities for attempting to restore the function of upper limbs affected under such conditions: microsurgical transfer of the gracilis muscle for elbow flexion. Methods: Eight patients were included, divi- ded into two groups: one in which the procedure consisted of neurorrhaphy of the muscle flap with sural nerve grafting and anastomosis more distally; and the other, in which the neurorrhaphy was performed directly on the spinal acces- sory nerve, with anastomosis in thoracoacromial vessels. Re- sults: We found a significant difference between the groups. A greater number of satisfactory results (75% M4) were found among patients who underwent direct neurorrhaphy, whereas the procedure using grafts for neurorrhaphy was less succes- sful (25% M4). Conclusion: Patients who underwent micro- surgical functional transfer of the gracilis muscle in which vascular anastomoses were performed in thoracoacromial vessels presented better functional outcomes than shown by those whose anastomoses were in the brachial artery with subsequent use of a nerve graft.