Brachial plexus injury - from double to triple FFMT

Introduction The concept of double free functioning muscle transfer (DFFMT) reconstruction for total arm type brachial plexus injury (BPI) had been successfully reported by Professor Doi from Japan. However, to overcome the weakness of finger/wrist extension after serving two functions by one gracilis muscle as described by Doi, we invented a new method of triple FFMT. This study was aimed to evaluate the clinical effectiveness of triple FFMT for total arm type BPI reconstruction. Methods From 2001 to 2010, 85 patients received FFMT for total arm type BPI. Five patients were excluded from this study due to inadequate vascular pattern (type B2) for DFFMT. Therefore, we had total 80 patients received the 1 stage free gracilis-adductor DFFMT and the 2 stage single gracilis FFMT; so called “Triple FFMT”; for complete total avulsion BPI. There were 70 males and 10 females. The average age was 33.5 years old. The shoulder function was reconstructed by neurotization.