Clinical Presentation
Active elbow extension is essential for numerous activities of daily living, highlighting its importance in the functional recovery of tetraplegic patients [PMID:19516135].
Management
In a cadaveric study [PMID:21503973], transferring branches from the axillary nerve, specifically the teres minor or posterior deltoid, to the triceps motor branches via an axillary approach demonstrated anatomical feasibility and comparable nerve diameters and myelinated fiber counts, suggesting potential for improved elbow extension outcomes compared to traditional muscle transfers.
The study [PMID:21503973] revealed that the teres minor motor branch, posterior deltoid branch, and triceps motor branches have similar dimensions and fiber counts, indicating their potential utility as reliable donor nerves for reconstructive procedures in spinal cord injury patients.
The posterior deltoid-to-triceps tendon transfer was developed to restore active elbow extension, a critical function for activities of daily living in individuals with tetraplegia, yielding good functional results and high patient satisfaction [PMID:19516135].
Prognosis & Follow-up
While the anatomical feasibility of nerve transfers [PMID:21503973] shows promise, the paper emphasizes the necessity for subsequent clinical studies to evaluate long-term efficacy and patient-specific outcomes compared to existing surgical techniques.
High levels of patient satisfaction have been reported following the posterior deltoid-to-triceps tendon transfer procedure, indicating positive long-term outcomes [PMID:19516135].
References
1 Bertelli JA, Tacca CP, Winkelmann Duarte EC, Ghizoni MF, Duarte H. Transfer of axillary nerve branches to reconstruct elbow extension in tetraplegics: a laboratory investigation of surgical feasibility. Microsurgery 2011. link 2 Bonds CW, James MA. Posterior deltoid-to-triceps tendon transfer to restore active elbow extension in patients with tetraplegia. Techniques in hand & upper extremity surgery 2009. link
2 papers cited of 3 indexed.