Triceps to biceps transfer for restoration of elbow flexion following upper brachial plexus injury

Rao, Pothula Durga Prasada; Rao, Rayidi Venkata Koteswara; Srikanth, R.

doi:10.4103/ijps.ijps_225_16

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…For the same reason, even if good elbow flexion is accomplished (Rao et al, 2017), we view triceps to biceps transfer as a procedure with poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

Intercostal nerve transfer in management of biceps and triceps co‐contraction in brachial plexus birth palsy

Misra,

Takagi,

Yamaguchi

et al. 2024

Microsurgery

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ObjectiveBrachial plexus birth palsy (BPBP) is often caused by traction during birth. In some cases, reinnervation occurs during spontaneous recovery and it causes involuntary co‐contraction between antagonistic muscles. When it comes up between the biceps and triceps muscles, smooth active motion of the elbow joint is impaired. We are presenting outcomes of intercostal nerve (ICN) to radial nerve transfer to minimize elbow motion abnormality due to co‐contraction.MethodsWe present five cases (two males and three females) of biceps and triceps co‐contraction in BPBP patients treated from 2005 to 2018. The mean age at surgery was 9.36 years (range, 4.8–16.4 years). They were treated by ICNs transfer to motor branch of the radial nerve to the triceps muscle. Preoperative electromyography was done in all cases to confirm biceps and triceps co‐contraction and to assess the contractile status of both muscles. A 10‐s flexion extension test was done pre and postoperatively to assess the efficacy of our procedure.ResultsThe postop course was uneventful. No donor site morbidity or respiratory complications were recorded in any patient. The mean postoperative follow‐up period was 83.9 months (range, 53.6–135.5 months). At the final follow‐up, elbow flexion was M4 in the Medical Research Council (MRC) grading scale in all five patients and elbow extension was graded M4 or M4− in all five patients. There was significant increase in the 10 s flexion extension test results delineating the effectiveness of the procedure.ConclusionsICNs transfer to motor branch of the radial nerve to the triceps muscle for management of biceps and triceps co‐contraction in BPBP is a good option with minimal morbidity and good success rate.

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“…For the same reason, even if good elbow flexion is accomplished (Rao et al, 2017), we view triceps to biceps transfer as a procedure with poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

Intercostal nerve transfer in management of biceps and triceps co‐contraction in brachial plexus birth palsy

Misra,

Takagi,

Yamaguchi

et al. 2024

Microsurgery

View full text Add to dashboard Cite

show abstract

“…In general, they reported good results; however, approximately one-third of their patients did not achieve any elbow flexion. 9 Carrol and Hill reported 15 patients who were treated with transfer of the entire triceps. They found that this transfer provides predictable benefit in patients who lack elbow flexion due to traumatic injuries, but not in patients with arthrogryposis.…”

Section: Discussionmentioning

confidence: 99%

Long Head of Triceps Tendon Transfer for Agenesis of Biceps and Brachialis: Two Cases

Türker

Richard

Benson

2022

Hand (New York, N,Y.)

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Congenital lack of elbow flexion results in significant disability and may be seen in conjunction with syndromes, plexopathies, neuromuscular disorders, or as an isolated muscular agenesis of elbow flexors. There are many tendon transfer options to address this issue, but there is a lack of data on the functional results in the pediatric population. In this series, we present 1 patient with isolated muscular agenesis of the biceps and brachialis musculotendinous units and another with this same muscular agenesis in the setting of arthrogryposis. They were treated with anterior ulnar nerve transposition and transfer of the long head of triceps tendon around 2 years of age resulting in functional elbow flexion in both patients.

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“…In this patient with flexor elbow strength of M = 0 and in which a large part of the muscles of the shoulder and elbow region had suffered some damage, the muscle options only targeted the triceps with strength evaluation M = 5, so it was the muscle used and that according to some authors the one with the best results as well as the latissimus dorsi [8]. Transfers of this muscle can be performed completely, but with the drawback of the loss of active extension [4,5,8] or using the long head of the triceps only, since it has independent innervation and vascularization and even authors in studies of cadaveric dissection suggest that this muscle belly is innervated in many cases by the axillary or ulnar nerve and not by the radial nerve exclusively [4,5,[9][10][11][12]. For this reason, the long head of the triceps can not only be used to perform a free muscle flap without creating great local morbidity, but it can also be used with good results to regain flexion of the elbow without losing the extension of this joint and using a relatively easy technique to execute [4,13].…”

Section: Discussionmentioning

confidence: 99%

“…Orthopedics and Rheumatology Open Access Journal (OROAJ) in 70º flexion. The two wounds are closed with the placement of drainage tubes that are removed at 72 hours, the stitches at 10 days being immobilization for four weeks with the elbow at 90º [4,5]. Once the immobilization is removed, a rehabilitation plan is started with flexion exercises in favor of gravity and then exercises against gravity resistance.…”

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confidence: 99%

Catastrophic Member. Restoration of Elbow Flexion by Transferring Long Head from Triceps to Biceps

Pazos¹

2021

OROAJ

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Introduction: Catastrophic injuries to the upper limb are devastating injuries that affect many essential structures of the hand, forearm, arm and adjacent organs, which almost always lead to significant disability, directly or through the psychosocial impact that it represents. Therefore, recovering essential limb functions represents a challenge for orthopedists.Objective: To present a new technique in our environment, which behaved as the most useful variant to regain flexion of the elbow without loss of other functions in this patient.Case Presentation: 58-year-old male mestizo patient, who is treated at our institution for an occupational accident with a practically disarticulated right upper limb at the elbow and shoulder with avulsive soft tissue lesions including radial nerve and cutaneous muscle. The loss of active elbow flexion because of the neurological injury suffered was restored with the transfer of the long head of the triceps brachii to the distal biceps brachii tendon, recovering flexion against resistance without loss of extension. Conclusions:The transfer of the long head of the triceps brachii to recover active flexion of the elbow is a not very complex technique with little morbidity and without loss of active elbow extension, which in our patient managed to recover important functions of the injured limb.

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Triceps to biceps transfer for restoration of elbow flexion following upper brachial plexus injury

Cited by 8 publications

References 20 publications

Intercostal nerve transfer in management of biceps and triceps co‐contraction in brachial plexus birth palsy

Intercostal nerve transfer in management of biceps and triceps co‐contraction in brachial plexus birth palsy

Long Head of Triceps Tendon Transfer for Agenesis of Biceps and Brachialis: Two Cases

Catastrophic Member. Restoration of Elbow Flexion by Transferring Long Head from Triceps to Biceps

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