Email this article Restoration of elbow active flexion via latissimus dorsii transfer in patients with arthrogryposis
- Authors: Agranovich O.E.1, Kochenova E.A.1, Trofimova S.I.1, Petrova E.V.1, Buklaev D.S.1
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Affiliations:
- The Turner Scientific Research Institute for Children’s Orthopedics
- Issue: Vol 6, No 3 (2018)
- Pages: 5-11
- Section: Original papers
- URL: https://bakhtiniada.ru/turner/article/view/10222
- DOI: https://doi.org/10.17816/PTORS6273-75
- ID: 10222
Cite item
Abstract
Background. Severe hypoplasia (or aplasia) of the biceps brachii is a primary cause of restriction in activities of daily living in patients with arthrogryposis.
Aim. To estimate the possibility of restoring elbow active flexion via a latissimus dorsii transfer in patients with arthrogryposis.
Materials and methods. From 2011 to 2018, we restored active flexion of the elbow via a latissimus dorsi transfer to the biceps brachii in 30 patients with arthrogryposis (44 upper limbs). We used different regimes including clinical examinations, EMG donor and recipient sites, and CT of the chest wall and shoulder.
Results. The mean age of the patients was 4.0 ± 2.4 years, and the follow-up period was 3.2 ± 1.9 months. Follow-up results were available for 26 patients (30 upper limbs). The active postoperative elbow motion was 90.5 ± 14.9°. Elbow extension limitation occurred in 51% of cases (12.8 ± 4.3°) without any problems in activities of daily living. In total, 55.6% of patients had good results, 33.3% had satisfactory results, and 11.1% had poor results.
Discussion. Our latissimus dorsi transfer results were comparable with those of other authors. Transposition of the latissimus dorsi to the biceps brachii restores sufficient flexion of the elbow without severe elbow flexion contractures.
Conclusions. We suggest pedicle monopolar latissimus dorsi transfer as a reliable therapeutic option to restore active elbow flexion in patients with arthrogryposis having passive elbow flexion of 90° or higher before operation and donor muscle strain grade 4 or higher.
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##article.viewOnOriginalSite##About the authors
Olga E. Agranovich
The Turner Scientific Research Institute for Children’s Orthopedics
Author for correspondence.
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
MD, PhD, Professor, Head of the Department of Arthrogryposis.
Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Evgeniya A. Kochenova
The Turner Scientific Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
MD, PhD, Surgeon of the Department of Arthrogryposis
Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Svetlana I. Trofimova
The Turner Scientific Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
MD, PhD, Researcher of the Department of Arthrogryposis
Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Ekaterina V. Petrova
The Turner Scientific Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
MD, PhD, Senior Researcher of the Department of Arthrogryposis
Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603Dmitriy S. Buklaev
The Turner Scientific Research Institute for Children’s Orthopedics
Email: olga_agranovich@yahoo.com
MD, PhD, Chief of the Department of Arthrogryposis
Russian Federation, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603References
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