[Nerve and muscle transfer surgery to restore paralyzed elbow function]

• Paralysis of elbow flexion or extension leads to major impairment of upper extremity function. Surgical reconstruction can be achieved using several procedures.If the time interval since the nerve injury is short, anatomic reconstruction by means of nerve suture or nerve transplantation should be attempted. Alternatively, nerve transposition is possible. If more than 12-18 months have elapsed, reinnervation of arm muscles can no longer be expected. In this case, muscle transposition is helpful. Restoring flexion is predominantly required following brachial plexus injury, when the function of the biceps, brachioradialis and brachialis muscles are lost. As donor muscles the latissimus dorsi, pectoralis major and triceps brachii can be used, alternatively a transfer of the flexor-pronator muscles of the forearm is possible. Latissimus dorsi transfer to reconstruct elbow flexion is also indicated in defects of the anterior upper arm muscle compartiment due to trauma, ischemia, or tumor. Patients with proximal radial nerve lesions may benefit from latissimus transfer to reachieve elbow flexion extension.In tetraplegic patients, elbow extension is restored mainly by transfer of the posterior deltoid muscle extended with a tendon graft, or by means of a biceps-to-triceps transfer.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

Brachial Plexus/*injuries/surgery

Elbow Joint/*innervation

Humans

Muscle Strength/physiology

Muscle

Skeletal/*innervation/*transplantation

Nerve Regeneration/physiology

Nerve Transfer/*methods

Paresis/*surgery

Peripheral Nerves/transplantation

Peripheral Nervous System Diseases/*surgery

Postoperative Care

Range of Motion

Articular/physiology

Publication and Content Type

ref (subject category)

art (subject category)