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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Restoration of elbow active flexion via monopolar latissimus dorsii transfer in patients with arthrogryposis

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  • presenting/speaker Olga Agranovich - The Turner Scientific Institute for Children's Orthopedics, St.-Petersburg, Pushkin, Russia
  • Evgenya Kochenova - The Turner Scientific Institute for Children's Orthopedics, St.-Petersburg, Pushkin, Russia
  • Svetlana Trofimova - The Turner Scientific Institute for Children's Orthopedics, St.-Petersburg, Pushkin, Russia
  • Ekaterina Petrova - The Turner Scientific Institute for Children's Orthopedics, St.-Petersburg, Pushkin, Russia
  • Dmitry Buklaev - The Turner Scientific Institute for Children's Orthopedics, St.-Petersburg, Pushkin, Russia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-343

doi: 10.3205/19ifssh1104, urn:nbn:de:0183-19ifssh11041

Published: February 6, 2020

© 2020 Agranovich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: One of the main causes of restriction in daily-living activities in patients with arthrogryposis is severe hypoplasia (or aplasia) of biceps brachii.

The aim of this research was to estimate the possibility of restoration of elbow active flexion via monopolar latissimus dorsii transfer in patients with arthrogryposis.

Methods: From 2011 to 2018 we performed restoration of elbow active flexion vie latissimus dorsii transfer to biceps brachii in 30 patients with arthrogryposis (44 upper limbs). We used clinical examination, EMG donor and recipient sites, CT chest wall and shoulder in different regimes.

Results and Conclusions: The patients were a mean age of 4,0±2,4 years. The follow-up period was 3,2±1,9 months. The follow-up results were estimated in 26 patients (30 upper limbs). The active postoperative elbow motion was 90,5±14,9°. Limitation of elbow extension was in 51% cases (12,8±4,3°) without problem in daily living. Good results were in 55,6%, satisfactory in 33,3%, poor in 11,1% cases.

Our results of latissimus dorsi transfer were comparable with other authors. Transposition of latissimus dorsi to the biceps brachii allows to restore sufficient flexion of the elbow without severe elbow flexion contractures.

We suggest pedicle monopolar latissimus dorsi transfer as a reliable therapeutic option to restore active elbow flexion in patients with arthrogryposis in cases with passive elbow flexion 90° and more before operation and donor muscle strange grade 4 and more.