Objective: The primary objective of our study was to evaluate the results of the free transfer of the gracilis muscle with neurotization in the ulnar nerve to recover the elbow flexion strength in patients with upper brachial plexus injury. Methods: We performed retrospective study that evaluated 21 patients with upper brachial plexus injury. The patients underwent surgical treatment free transfer of the gracilis muscle (21 patients, the free group) for elbow flexors with neurotization in part of the ulnar nerve. The primary outcome was evaluated using the scale defined by The British Medical Research Council (BMRC) and a minimum follow-up of 12 months was defined. The BMRC scale classifies muscle strength from M0 (no contraction) to M5 (normal strength). We used the criteria of M4 or more to classify the elbow flexion as a good result. Results: The ability to obtain an M4 score or higher was 61.9% in the free groups. Considering the possibility of an M2 score or higher, which would allow for complementary surgery, 95.2% of patients in the free group obtained this score. Conclusion: The free transfer of the gracilis muscle and neurotization in the ulnar nerve in patients with upper brachial plexus injury showed satisfactory results considering the elbow flexion strength.
