Musculocutaneous neurectomy for spastic elbow flexion in non-functional upper extremities in adults

The charts of twenty-nine patients who had undergone thirty musculocutaneous neurectomies for acquired spasticity of the elbow in a non-functional upper extremity were reviewed. The most common causes of the spasticity were cerebrovascular accident (59 per cent) and head injury (24 per cent). The aims of the operation were to increase the patient's capacity for self-care and to improve ambulation, personal hygiene, and appearance. Patients who had 30-degree flexion contractures preoperatively did not require a cast postoperatively; those who had 30 to 75-degree flexion contractures preoperatively required a cast postoperatively; and patients who had flexion contractures of more than 75 degrees preoperatively required a concomitant release of soft tissue in the elbow and application of a cast postoperatively. One patient who was operated on to improve appearance had no active elbow flexion postoperatively and was regarded as having a poor result. Musculocutaneous neurectomy is a safe, reliable procedure for treating the spastic elbow in the non-functional upper extremity.