Flexorplasty of the elbow.

Sixteen patients (mean age, 31.6 years) whose elbow flexor power was absent or inadequate were treated with the following muscle transfer procedures: (1) bipolar pectoralis major transfer in five, (2) unipolar or bipolar latissimus dorsi transfer in five, (3) free latissimus dorsi transfer in three, and (4) triceps-to-biceps transfer in three. None of the patients in this series was a candidate for proximal advancement of the forearm muscles. At the follow-up evaluation (mean, 31.5 months), the mean antigravity elbow flexion arcs obtained from each procedure were as follows: pectoralis transfer, 91 degrees; latissimus dorsi transfer, 87 degrees; free latissimus dorsi transfer, 11 degrees; and triceps-to-biceps transfer, 125 degrees. The results were equally favorable for the pectoralis and latissimus dorsi transfer. Triceps transfer was reliable for restoration of an excellent range of elbow flexion, but active elbow extension was lost. Poor results were obtained with the free latissimus dorsi transfers.