Tendon transfer from a re-innervated triceps to the biceps for restoration of elbow flexion in total brachial plexus palsy

Abstract

ObjectivesThis study aimed to evaluate the outcomes of the tendon transfer from a reinnervated triceps to biceps in the context of total brachial plexus palsy. MethodsWe conducted a retrospective study. Patients had reinnervation of the triceps either by spontaneous recovery or by nerve transfer. Functional results were assessed by strength and range of motion. The level of patient satisfaction was measured on a scale from 0 to 10. ResultsSix patients (6 transfers) were included. Two triceps had spontaneous reinnervation and the other four through neurotization of intercostal nerves. All patients recovered strength to M4 in flexion with an average secondary deficit of 10° (5°–15°). The mean level of satisfaction was measured at 7/10 (6–8). ConclusionsThis tendon transfer is a reliable and simple solution for supportive restoration of elbow flexion. Systematic reinnervation of active extension of the elbow should be proposed for the gain in function that it represents but also for the supportive therapeutic opportunity that it offers should nerve surgery for elbow flexion fail. Level of evidence4.