Before & After Pictures - Adult Modified Quad Procedure


Publication At-A-Glance

Modified Quad Surgery Significantly Improves The Median Nerve Conduction
and Functional Outcomes In Obstetric Brachial Plexus Nerve Injury

The Modified Quad Procedure, for patients with obstetric brachial plexus nerve injury, includes muscle release and transfer and a decompression of nerves to the hand that travel through the armpit area. We wanted to know if the Modified Quad Procedure improved nerve and muscle function of the hand for these patients, in addition to the proven benefits to the shoulder.

All patients were evaluated using video recordings of standardized movements and the modified Mallet scale to classify active shoulder movements. We also used "nerve conduction" tests to evaluate the median nerve (the main nerve to the hand) before and after Modified quad surgery. This is a very sensitive method to detect brachial plexus and other nerve injuries. Patients had multiple areas tested. We followed up with the patients for (up to) 43 months after surgery.

After reviewing the pre-op and post op tests, the results showed that the nerve responses in the neck area were significantly lower on the affected side. Most importantly, we found that there was significant improvement in the median nerve response, which should improve hand function in addition to shoulder abduction.

For a copy of this publication please contact Texas Nerve & Paralysis Institute at or click here to Download

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