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Related Experiment Videos

Steindler and pectoralis major flexorplasty: a comparative analysis

D E Beaton1, A Dumont, M B Mackay

  • 1Upper Extremity Reconstructive Service, St Michael's Hospital, Toronto, Ontario, Canada.

The Journal of Hand Surgery
|September 1, 1995
PubMed
Summary

For brachial plexus injuries, pectoralis major tendon transfer is as effective as the Steindler procedure for restoring elbow flexion. Both surgical techniques demonstrated comparable functional outcomes and patient satisfaction.

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Brachial Plexus Injury Management

Background:

  • Restoring elbow flexion is crucial for patients with brachial plexus injuries.
  • Previous studies have not directly compared the Steindler procedure and pectoralis major tendon transfer for elbow flexorplasty.
  • Both procedures are considered for irreparable brachial plexus lesions or those unresponsive to other treatments.

Purpose of the Study:

  • To compare the functional outcomes of pectoralis major tendon transfer versus the modified Steindler procedure for elbow flexorplasty in patients with brachial plexus injuries.
  • To evaluate objective and subjective measures of recovery after these surgical techniques.

Main Methods:

  • A comparative study of 14 patients with brachial plexus injuries undergoing shoulder arthrodesis and elbow flexorplasty.

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  • Five patients received pectoralis major tendon transfer, and nine underwent a modified Steindler procedure.
  • Functional outcomes were assessed using questionnaires, range of motion, isometric and isotonic strength testing (BTE Work Simulator), grip, and pinch strength at an average 60-month follow-up.

    • Main Results:

    • Significant improvement in daily activities (dressing, bilateral tasks) and overall function was observed postoperatively compared to preoperative status.
    • No statistically significant differences (p = .05) were found between the pectoralis major transfer and Steindler groups in objective functional tests.
    • Subjective measures also showed comparable results between the two surgical techniques.

    Conclusions:

    • Pectoralis major tendon transfer is an effective alternative to the modified Steindler procedure for restoring elbow flexion in patients with brachial plexus injuries requiring shoulder stabilization.
    • Both techniques offer equivalent functional recovery in terms of range of motion, strength, and patient-reported outcomes.