Cross pectoral nerve transfer following free gracilis muscle transplantation for chronic brachial plexus palsy: a case series.

In an eight year period, 12 patients were treated by the contra-lateral medial pectoral nerve as motor nerve innervation of the transplanted free gracilis muscle to the paralytic upper limb. The gracilis muscle was used for both elbow and digital flexion. Results were assessed by the MRC grading system and success was defined as muscle strength of M4 and M3 which was observed in seven patients (58%). The motor level of the muscle in two patients was M0 and in two it was M1 to M2. The donor pectoral muscle of these 12 patients showed no deficit in motor and sensory functions. This method can be used for treatment of brachial plexus palsy, regaining useful function of the reconstructed limb.