Tendon transfers to restore elbow flexion after traumatic paralysis of the brachial plexus in adults.

Loss of elbow flexion after traumatic brachial palsy produces significant functional and cosmetic problems. Although a direct approach to the neurological lesion with an attempt to reinnervate the biceps has given some encouraging results, these can be incomplete and for this reason tendon transfers still have an important role. We report the results of our series of 60 patients (54 men and 6 women) who have undergone tendon transfer between 1984 and 1994. The transfers were performed during or after nerve surgery, and we used the muscles arising from the medial epicondyle, the pectoralis minor and the triceps. Our results were judged on any improvement in shoulder stability and in the power of lateral rotation, together with the power and range of active and passive flexion of the elbow. Good results were achieved in 74% of the patients in our study, with more than 120 degrees of elbow flexion and an ability to support at least 1 kg with the elbow flexed to 90 degrees.