Biceps to Triceps Transfer in Tetraplegic Patients: Our Experience and Review of the Literature

HAND, 2017 · DOI: 10.1177/1558944716646764 · Published: January 1, 2017

Simple Explanation

Tetraplegic patients often experience significant functional deficits, affecting their ability to perform daily activities. This study focuses on a surgical technique, biceps-to-triceps transfer, to restore elbow extension in these patients. The primary goal of this surgery is to enable patients to regain independence by improving their ability to extend their elbows. Elbow extension is crucial for tasks like dressing, using a wheelchair, and reaching for objects. The Zancolli's modified technique involves transferring the biceps tendon to the triceps tendon, which helps to restore the ability to extend the elbow. The study shows that this technique is effective and has few complications.

Study Duration

45 Months

Participants

4 patients (6 biceps-to-triceps transfers)

Evidence Level

Retrospective study

Key Findings

1
All patients who underwent the biceps-to-triceps transfer achieved full and active elbow extension against gravity 12 months after surgery.
2
The average DASH (Disabilities of the Arm, Shoulder and Hand) score significantly improved from 73.2 preoperatively to 20.8 twelve months postoperatively.
3
One patient experienced a temporary loss of elbow flexion, which was resolved with a specific program of rehabilitation and muscle strengthening.

Research Summary

This retrospective study evaluated the functional outcomes of biceps-to-triceps transfer surgery using Zancolli's modified technique in tetraplegic patients. The study included 6 biceps-to-triceps transfers in 4 patients with a mean follow-up of 45 months. The results showed that all patients achieved full and active elbow extension against gravity, with a significant improvement in DASH scores. This indicates a substantial improvement in their ability to perform daily activities. The study concludes that Zancolli's modified technique is a simple and effective method for restoring elbow extension in tetraplegic patients, leading to increased autonomy and a low rate of complications.

Practical Implications

Improved patient autonomy

Restoring elbow extension allows tetraplegic patients to perform daily tasks independently, increasing their quality of life.

Effective surgical technique

Zancolli's modified biceps-to-triceps transfer is a reliable method for achieving active elbow extension with a low complication rate.

Consideration for secondary procedures

With improved elbow extension, patients may be able to undergo further surgeries to improve hand function and grip strength.

Study Limitations

1
Retrospective study design
2
Limited number of cases
3
Use of DASH questionnaire, which may not be specifically validated for tetraplegic patients

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