Bipolar Latissimus Dorsi Transfer for Arthrogryposis Multiplex Congenita: Minimum 10-Month Follow-Up

Frizzell, Kaela; Kozin, Scott H.; Zlotolow, Dan A.

doi:10.1016/j.jhsa.2020.04.025

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Our preferred reconstructive choice is bipolar latissimus dorsi transfer; 52 another common option in arthorgryposis is triceps to biceps, transferring the long head with the goal to achieve an active elbow flexion preserving active extension. 53 …”

Section: Obstetrical Brachial Plexus Injuriesmentioning

confidence: 99%

“…50 The absence of elbow flexion crease is an obvious sign and allows, in some cases, the differential diagnosis of neonatal brachial plexus palsy. 51 Our preferred reconstructive choice is bipolar latissimus dorsi transfer; 52 another common option in arthorgryposis is triceps to biceps, transferring the long head with the goal to achieve an active elbow flexion preserving active extension. 53 Otherwise, a free gracilis muscle was transplanted (Figure 11).…”

Section: Microsurgery In Congenital Deficienciesmentioning

confidence: 99%

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Microsurgery in pediatric upper limb reconstructions: An overview

Catena

Baldrighi

Jester

et al. 2022

Journal of Children's Orthopaedics

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The use of microsurgery has spread during the last decades, making resolvable many complex defects considered hitherto inapproachable. Although the small vessel diameter in children was initially considered a technical limitation, the increase in microsurgical expertise over the past three decades allowed us to manage many pediatric conditions by means of free tissue transfers. Pediatric microsurgery has been shown to be feasible, gaining a prominent place in the treatment of children affected by limb malformations, tumors, nerve injuries, and post-traumatic defects. The aim of this current concepts review is to describe the more frequent pediatric upper limb conditions in which the use of microsurgical reconstructions should be considered in the range of treatment options.

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Section: Obstetrical Brachial Plexus Injuriesmentioning

confidence: 99%

Section: Microsurgery In Congenital Deficienciesmentioning

confidence: 99%

Microsurgery in pediatric upper limb reconstructions: An overview

Catena

Baldrighi

Jester

et al. 2022

Journal of Children's Orthopaedics

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“…After gaining passive elbow flexion with a release, active elbow flexion can be achieved in order of preference by a bipolar latissimus transfer, a monopolar lower pectoralis transfer, a partial triceps transfer, a free gracilis transfer, or a Steindler procedure. 35 Elbow flexion contractures with a pterygium are more difficult to manage. The most predictable surgical plan is a trapezoidal posterior closing wedge distal humeral osteotomy to reorient the child's arc of motion into more extension.…”

Section: Elbowmentioning

confidence: 99%

The Orthopaedic Management of Arthrogryposis Multiplex Congenita

Bosse¹,

Zlotolow²

2021

Journal of the Pediatric Orthopaedic Society of North America

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Arthrogryposis multiplex congenita (AMC) is a term that describes at least 400 different conditions that result in a baby born with multiple joint contractures. The underlying similarity of these causative conditions is that the developing baby experiences fetal akinesia. The most common forms of AMC are Amyoplasia, or “classic arthrogryposis”, and the different kinds of distal arthrogryposis. Over the past two decades, the orthopaedic treatment of children with arthrogryposis multiplex congenita has steadily evolved steadily, with a better appreciation of the functional potential of persons with arthrogryposis. The development of newer procedures specific for the arthrogrypotic deformities have improved surgical treatment, and outcomes studies that provide understanding of the overall capabilities of adults with arthrogryposis continue to help determine which treatments were the most beneficial. The outcome studies indicate that most adults with arthrogryposis are ambulatory, but less than half are fully independent in self-care, most are limited by upper extremity dysfunction. Pain in adulthood, both chronic and episodic, is frequent, particularly of the foot and back, limiting ambulation and standing. To improve independence, upper extremity treatments have advanced to improve elbow motion, and wrist and thumb positioning. In the lower extremities, attempts to improve the ambulatory ability and decrease future pain include correction of hip and knee contractures, and emphasizing casting treatments of foot deformities. Pediatric patients with arthrogryposis require a careful evaluation, with both a physical examination and an assessment of needs to direct their treatment. Further outcomes studies are needed to continue to refine procedures and define the appropriate candidates.

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