Open Access
American Research Journal of Orthopedics and Traumatology
ISSN (Online): 2572-2964
DOI: 10.46568/arjot
Independent elbow flexion and extension by isolated long head of triceps transfer for reconstruction of elbow flexion in old upper brachial plexus palsy
1Assistant professor of Orthopedic Surgery – Zagazig University
2Assistant professor of Orthopedic Surgery – Zagazig University
2Assistant professor of Orthopedic Surgery – Zagazig University
Mohammad Abd El Aziz Ali MD, and Reda H El-kady MD, “Independent elbow flexion and extension by isolated long head of triceps transfer for reconstruction of elbow flexion in old upper brachial plexus palsy”.
American Research Journal of Orthopedics and Traumatology. 2020; 4(1): 1-6.
American Research Journal of Orthopedics and Traumatology. 2020; 4(1): 1-6.
Abstract
Objective: To evaluate the functional outcome of pedicled functional isolated long head of triceps transfer to
biceps tendon in failed primary nerve repair or patients seek treatment after 18 month from injury of upper
brachial plexus palsy for elbow flexion. Restoring elbow flexion with preserved elbow extension as total transfer
of triceps to biceps tendon sacrifices active extension so in our cases we preserve the medial head which is the
main elbow extensor and lateral head of triceps.
Methods : Our study, including only patients who had biceps grade 0 - 2 and triceps grade 4 – 5 in injury of
upper brachial plexus palsy , who underwent anterior transfer of isolated long head of the triceps muscle. The
affected left side (10) , right side (8) sex ( 12 male ) ( 6 female ) , type of accident ( obstetric brachial plexus
palsy (6) , traumatic brachial plexus palsy (12) strength of elbow flexion, complications and patient satisfaction
were investigated in 18 cases.
Results: the age range was from 3 to 52 years, with a mean of 25.7 years. The minimum time between injury and
surgery was 18 months (range 18-74 months). All the patients at final follow up said that they were satisfied
with the procedure. Evaluation Of Elbow function according to Pothula ( 2017 ) after Independent elbow flexion
and extension by isolated long head of triceps transfer for reconstruction of elbow flexion : very good results in
10 cases (55.6 %) , good results in 5 cases ( 27.8 ) , fair results in 2 cases ( 11.1 % ) and failure results in 1 case
( 5.6 %). So Satisfactory results of isolated long head of triceps transfer for reconstruction of elbow flexion in
upper brachial plexus palsy was in 15 cases (83.4 %). Fair results was in 2 cases who were in the left side injury
which were not the dominant side of the cases and the patients were satisfied and also failure results in 1 case
who revised surgery and operated with lateral head of triceps to biceps and tensioning and the patient was
satisfied. 3 cases had complications (initial hematoma in 2 cases and insufficient tensioning in 1 case).
Conclusion: Restoring elbow flexion with preserved elbow extension as total transfer of triceps to biceps tendon
sacrifices active extension. Independent elbow flexion and extension by isolated long head of triceps transfer to
biceps tendon in old brachial plexus palsy is effective, simple and less technically demanding procedure.
biceps tendon in failed primary nerve repair or patients seek treatment after 18 month from injury of upper
brachial plexus palsy for elbow flexion. Restoring elbow flexion with preserved elbow extension as total transfer
of triceps to biceps tendon sacrifices active extension so in our cases we preserve the medial head which is the
main elbow extensor and lateral head of triceps.
Methods : Our study, including only patients who had biceps grade 0 - 2 and triceps grade 4 – 5 in injury of
upper brachial plexus palsy , who underwent anterior transfer of isolated long head of the triceps muscle. The
affected left side (10) , right side (8) sex ( 12 male ) ( 6 female ) , type of accident ( obstetric brachial plexus
palsy (6) , traumatic brachial plexus palsy (12) strength of elbow flexion, complications and patient satisfaction
were investigated in 18 cases.
Results: the age range was from 3 to 52 years, with a mean of 25.7 years. The minimum time between injury and
surgery was 18 months (range 18-74 months). All the patients at final follow up said that they were satisfied
with the procedure. Evaluation Of Elbow function according to Pothula ( 2017 ) after Independent elbow flexion
and extension by isolated long head of triceps transfer for reconstruction of elbow flexion : very good results in
10 cases (55.6 %) , good results in 5 cases ( 27.8 ) , fair results in 2 cases ( 11.1 % ) and failure results in 1 case
( 5.6 %). So Satisfactory results of isolated long head of triceps transfer for reconstruction of elbow flexion in
upper brachial plexus palsy was in 15 cases (83.4 %). Fair results was in 2 cases who were in the left side injury
which were not the dominant side of the cases and the patients were satisfied and also failure results in 1 case
who revised surgery and operated with lateral head of triceps to biceps and tensioning and the patient was
satisfied. 3 cases had complications (initial hematoma in 2 cases and insufficient tensioning in 1 case).
Conclusion: Restoring elbow flexion with preserved elbow extension as total transfer of triceps to biceps tendon
sacrifices active extension. Independent elbow flexion and extension by isolated long head of triceps transfer to
biceps tendon in old brachial plexus palsy is effective, simple and less technically demanding procedure.
