Elbow extension

Reconstruction of elbow extension is an established treatment with a high degree of patient satisfaction. The D-T transfer is the most common method and has the advantage of inducing no serious complications; however, it necessitates a long period of healing and recovery. The Bi-T transfer is used much less frequently and, in the author's opinion, has few advantages compared with the D-T transfer. It is somewhat less time consuming to perform, and the rehabilitation period is a few weeks shorter. This method, however, has several drawbacks, including difficulties in learning to use the muscle as an extensor and a reduction of elbow flexion strength, which might result in a subjective functional loss. What is the best treatment for patients with a posterior deltoid that has a strength grade of 2 or 3: a D-T or Bi-T transfer or functional electrical stimulation? Today, this question is impossible to answer. The author is convinced that the optimal postoperative regimen for a reconstructed elbow extension has not been found yet.