Journal of Hand Surgery - June 2022 - S276

S276
Journal of Hand Surgery (Eur) 47(Supplement 1)
were included. Patients allocated to the motor imagery
group performed home-based kinaesthetic motor
imagery training 4 times a day for the duration of cast
immobilisation of 3-5 weeks. Controls received cast
immobilisation without motor imagery training.
Patient-reported wrist/hand evaluation (PRWE), grip
and pinch strength, range of motion, pain and pain
relief (VAS) were measured directly after cast
removal, and 2 weeks later.
Results: Out of 117 eligible patients, 24 and 19 participants
were included in the motor imagery and
control groups respectively. No statistically significant
differences were found in any of the outcome
variables directly after cast removal and 2 weeks
later. The median adherence (defined as the actual
number of training sessions divided by the advised
number of training sessions) to the motor imagery
training was 92% (IQR 85-95%).
Conclusions: Functional outcomes and pain after
independently performed home-based low intensity
motor imagery training were similar to standard care
in patients who sustained a distal radius fracture.
This indicates that independently performed, homebased
motor imagery training with low intensity does
not improve functional outcomes in elderly women
with a distal radius fracture.
A-1428 Transfer of Biceps to Long flexors for
restoration of finger flexion in traumatic brachial
plexus injuries
Vigneswaran Varadharajan, Praveen Bhardwaj,
Hari Venkatramani and S Raja Sabapathy
Ganga Medical Centre and Hospitals, Pvt. Ltd., Coimbatore,
India
Objective: Free functioning muscle transfer (FFMT)
is the main option for restoration of finger flexion in
secondary reconstruction of brachial plexus injuries.
However, the scarcity of donor nerves, often associated
vascular injuries and unpredictability of the outcome
are known challenges. Regional muscles
transfers using biceps, brachialis and brachioradialis
have been described but larger studies to assure
their role are lacking. We present our results of
using the biceps to long flexors transfer in patients
with lower plexus and total brachial plexus injuries.
Patients and
Methods: Between 2016 to 2020, 38 patients of traumatic
brachial plexus injuries have undergone this
procedure which include six patients who recovered
elbow flexion with FFMT and the recovered gracilis
muscle was used as the donor. The patients were
evaluated for the presence of useful grip, tip-palm
distance and satisfaction.
Results: All the patients at their early follow up
achieved finger flexion. 21 patients were available
for detailed assessment at a minimum of six
months following the surgery (6-48 months). Mean
age of the patients was 28.7 years. When passively
extended, all the patients were able to flex the fingers
till tip-palm distance of 2.5 cms. All the patients
were able to hook grip a bag containing weight of one
kilogram, able to hold and support objects for manipulation
with the normal hand and use the hand for
supporting a two-wheeler for driving. The average
DASH score was 28.4.
Conclusion: Biceps to finger flexors transfer is a reliable
option for restoration of finger flexion. In
patients with global involvement, it provided a supporting
hand, whereas, in patients with sufficient
proximal function, it even allowed independent use
of the hand. Overall, it provided a useful and predictable
reconstructive option for finger flexion in these
patients where the options are limited, and the function
achieved was satisfactory to a well-informed
patient.
A-1429 Revisiting cast removal complications via a
prospective controlled study: Improved safety with
a novel method
Adnan Sevencan
Eskis¸ehir Osmangazi University Hand Surgery Sub Dept.,
Eskisehir, Turkey
Objective: The first aim of this study was to prospectively
revisit the complications of cast removal, and
the second aim was compare the success rates of
conventional methods with that of our novel external-guided
skin protection aid method.
Methods: A total of 208 co-operative patients, over
5 years of age, and without any previous cast or splint
removal experience, were included in the 6-month
study period. Patients were selected arbitrarily and
divided into two study groups. In Group 1 (106
patients/115 casts, 60% male, average age of 20
years), conventional protection methods were used.
In Group 2 (102 patients/108 casts, 62% male, average
age of 26 years), novel, tong-shaped, externally
guided flexible steel plate aids were used for skin
protection. After inserting the base-protecting part
between the skin and cast materials, the upper part
of the aid guided the operators to stay in a safe line
during cast removal for injury-free cast cuts. The
cast removal procedures of each group were
observed and documented, including the detailedgraded
severity of skin injuries, burns, patient anxiety,
operator anxiety, and consumed processing
time.
Journal of Hand Surgery - June 2022

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