Gracilis Free Flap Technique for Elbow Flexion Reconstruction

Brachial plexus injuries (BPI) can be devastating for patients, often resulting in notable physical, psychological, and socioeconomic distress. To improve activities of daily living, the treatment of pan-plexus injuries focuses on restoring antigravity motion of the upper extremity, with elbow flexion being a high priority muscle group2. Although nerve transfers are an excellent option, this treatment path is not always viable. In such cases, free functioning muscle transfers, especially gracilis transfers, have emerged as a primary reconstructive approach, with excellent outcomes in complete BPI lesions.