Anatomical and clinical substantiation of the long head of triceps transposition to restore active forearm flexion in patients with arthrogryposis

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Abstract

Purpose: to investigate anatomic features of the long head of triceps brachii in relation to its using as a pedicle flap for restoration of active forearm flexion in patients with arthrogryposis. Material and methods. Anatomical studies were performed on 15 fresh frozen human upper limbs from 9 cadavers. Arteries were perfused with radiopaque masses and following preparation, sectional roentgenography, morphometry of anatomical structures were carried. 29 patients with the lack of active elbow flexion aged from 8 months to 15 years were examined (clinical, neurological and physiological studies) and treated in Turner Scientific and Research Institute for Children's Orthopedics from 2008 to 2012. Results and conclusion. Anatomical studies demonstrated the possibility of transposition of the long head of triceps to forearm flexors position. The long head of triceps can be simply separated from the other two heads, it has independent innervation and blood supply, its vascular pedicle is easily identified, and length of extraorgan vessels and nerves is sufficient to transfer the muscle as a pedicle flap. Clinical study has shown the principal possibility and effectiveness of restoration of active forearm flexion in patients with arthrogryposis using the long head of triceps brachii.

About the authors

S. I. Trofimova

Turner Scientific and Research Institute for Children 's Orthopedics

Author for correspondence.
Email: trofimova_sv2012@mail.ru
Russian Federation

N. F. Fomin

Kirov Military Medical Academy

Email: fominmed@mail.ru
Russian Federation

O. E. Agranovich

Turner Scientific and Research Institute for Children 's Orthopedics

Email: olga_agranovich@yahoo.com
Russian Federation

References

  1. Белоусов А.Е. Пластическая, реконструктивная и эстетическая хирургия. СПб.; 1998. 743 с.
  2. Новиков М.Л., Пшениснов К.П., Миначенко В.К. Восстановление сгибания в локтевом суставе при повреждениях плечевого сплетения. Анналы пластической, реконструктивной и эстетической хирургии. 2004; (4): 122.
  3. Сидорович Р.Р. Восстановление активного сгибания предплечья при последствиях травматического повреждения плечевого сплетения методом транспозиции трехглавой мышцы плеча. Белорусский медицинский журнал. 2005; (1): 85-87.
  4. Шведовченко И.В., Кочиш А.Ю., Голяна С.И., Орешков А.Б. Использование торакодоразального лоскута в детской ортопедии (анатомо-клиническое исследование). Травматология и ортопедия России. 2002; (3): 39-44.
  5. Biesalski K., Mayer L. Die Sehnenverpflanzung am Ellenbogen. Operation 19. Ersatz des M. biceps brachii durch den M. triceps brachii. Die physiologische Sehnenverpflanzung. Berlin: Springer; 1916: 284-286.
  6. Ezaki M. Treatment of the upper limb in the child with arthrogryposis. Hand Clin. 2000; 16 (4): 703-711.
  7. Gogola G.R., Ezaki M., Oishi S.N. et al. Long head of the triceps muscle transfer for active elbow flexion in arthrogryposis. Tech. Hand Up. Extrem. Surg. 2010; 14 (2): 121-124.
  8. Haninec P., Szeder V. Reconstruction of elbow flexion by transposition of pedicled long head of triceps brachii muscle. Acta Chir. Plast. 1999; 41(3): 82-86.
  9. Morrey B.F., Askew L.J., An K-N., Chao E.Y.S. A biomechanical study of normal functional elbow motion. J. Bone Joint Surg. 1981; 63-A: 872-877.
  10. Naidu S., Lim A., Poh L.K. et al. Long head of the triceps transfer for elbow flexion. Plast. Reconstr. Surg. 2007; 119 (3): 45e-47e.
  11. Rühmann O., Schmolke S., Gossé F. et al. Transposition of local muscles to restore elbow flexion in brachial plexus palsy. Injury. 2002; 33(7): 597-609.
  12. Terzis J.K., Kostopoulos V.K. The surgical treatment of brachial plexus injuries in adults. Plast. Reconstr. Surg. 2007; 119 (4): 73e-92e.
  13. Van Heest A., Waters P.M., Simmons B.P. Surgical treatment of arthrogryposis of the elbow. J. Hand Surg. 1998; 23-A: 1063-1070.

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