Flexor Power Restoration in Paralytic Elbow

Bae, Dae Kyung; Yoo, Myung Chul; Lee, Jae Sung; Ahn, Yong Sung

Abstract

Twelve cases with paralytic elbow due to a traumatic lesion of the brachial plexus (eleven cases) and to poliomyelitis (one case) were treated by elbow flexorplasty from April, 1978 to February, 1984 Seven cases with available muscle for transfer were treated by muscle transfer, three cases withwhole arm type brachial plexus injury were treated by gracilis muscle transplantation, and two relatively fresh cases by neurotization. The three operated groups were assessed in range of active elbow motion, muscle power testing, and electromyography at final follow-up. In eight cases, the elbow flexorplasty were augmented by shoulder arthrodesis. The mean length of follow-up was twenty two months. The mean arc of restored active elbow motion was 93 degrees following muscle transfer, 100 degrees following gracilis muscle transplatation, and 35 degrees following neurotization. The overall mean arc of active elbow motion was 77.5 degrees. In the muscle testing, the mean scores of the elbow flexor power were 3+, 4âˆ’, and 3âˆ’ following muscle transfer, grcilis muscle transplantation, and neurotization respectively. The overall mean score of restored elbow flexor power was 3âˆ’ . The electromyographic findings also revealed corresponding restoration of the action potential in the flexor muscle in the three groups. One case of the transfer group failed after sternocleidomastiod muscle transfer, who subsequently received gracilis muscle transplantation with satisfactory result.