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 6 publications

(3 citation statements)

References 20 publications

(24 reference statements)

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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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“…5 Various muscle transfers have been evaluated, performed and recommended like transfer of triceps to biceps or pectoralis major-minor to biceps and Steindler's flexorplasty alone or combined with wrist arthrodesis. [6][7][8][9] These procedures have been used sporadically and none has been propagated as the procedure of choice.…”

Section: Introductionmentioning

confidence: 99%

Unipolar pedicled latissimus dorsi transfer for elbow reanimation in traumatic brachial plexus injuries

Agrawal

Choudhary

Agrawal³

2020

Int J Res Med Sci

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Background: Brachial plexus injuries are troubling for the patients socially, economically and emotionally. Elbow joint being a large and vital joint needs to be reanimated so that the patient can carry out his routine work and bring the hand to the mouth. Number of procedures have been defined but latissimus dorsi being a large muscle is the muscle of choice for transfer in cases who present late. Bipolar latissimus dorsi transfers have often been reported but unipolar latissimus dorsi transfer has also been described. Authors have studied the unipolar muscle transfer, it’s surgical technique and results.Methods: In this study 18 patients were studied for demographic data, pre- and post-operative flexion of the elbow and the MRC grade of the corresponding movements. Diagnostic work up in the form of nerve conduction velocity, electromyography and magnetic resonance imaging were carried out and evaluated for their significance in traumatic brachial plexus injuries.Results: In this study 13 patients had avulsion of the C5-6 roots on magnetic resonance imaging. The patients presented after a period of 128.83±56.76 days. Substantial time elapsed and ruled out primary brachial plexus reconstruction or nerve transfers. The average elbow flexion improved from 6.67±5.69 degrees (range: 0-20 degrees) to 86.94±12.38 degrees (range: 65-110 degrees) following unipolar latissimus dorsi transfer. 12 patients (66.67%) developed M4 or M4+ power.Conclusions: Unipolar latissimus dorsi muscle transfer is a reliable method and most of the patients develop adequate strength and satisfactory function at the elbow joint.

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

Cited by 6 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

Unipolar pedicled latissimus dorsi transfer for elbow reanimation in traumatic brachial plexus injuries

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