Elbow extension.

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Physical Medicine and Rehabilitation

Background:

• Elbow extension reconstruction is a common procedure with high patient satisfaction.
• The Duchenne-Tendon (D-T) transfer is the most frequent technique, offering safety but requiring a lengthy recovery.
• The Brachialis-Internal (Bi-T) transfer is less common and presents potential drawbacks like reduced elbow flexion.

Purpose of the Study:

• To compare the D-T transfer, Bi-T transfer, and functional electrical stimulation for elbow extension reconstruction.
• To evaluate the effectiveness and patient outcomes of different treatment modalities for posterior deltoid weakness (strength grade 2-3).

Main Methods:

• Review of existing literature and clinical experience with D-T and Bi-T transfers.
• Discussion of functional electrical stimulation as a potential alternative treatment.

Main Results:

• The D-T transfer is associated with no serious complications but a prolonged healing period.
• The Bi-T transfer is quicker to perform and has a shorter rehabilitation but may lead to functional deficits and learning difficulties.
• Currently, there is insufficient evidence to definitively recommend one method over the others for patients with specific deltoid strength grades.

Conclusions:

• The optimal treatment for elbow extension reconstruction in patients with posterior deltoid weakness remains undetermined.
• Further research is necessary to establish the most effective postoperative regimen and compare surgical techniques with non-operative options like functional electrical stimulation.