Tetraplegia-Prospective Evaluation of Biceps to Triceps and Deltoid to Triceps for Elbow Extension in Tetraplegia

Prospective Evaluation of Biceps to Triceps and Deltoid to Triceps for Elbow Extension in Tetraplegia

Pdf Summary

This study evaluated and compared the outcomes of deltoid to triceps transfers and biceps to triceps transfers for restoration of elbow extension in young individuals with tetraplegia. Sixteen arms of 9 subjects with cervical-level spinal cord injuries were randomly assigned to undergo either a deltoid to triceps transfer or a biceps to triceps transfer. Elbow extension was successfully restored in both transfer groups. However, at the 24-month follow-up, the biceps transfers showed better results, with 7 of the 8 producing antigravity strength compared to only one arm with the deltoid transfer. Both groups experienced a loss of elbow flexion torque after surgery, with the deltoid group showing a 51% loss and the biceps group showing a 52% loss at three months post-surgery. By 24 months post-surgery, both groups still showed a loss of flexion torque, although the deltoid group improved to a 32% loss and the biceps group to a 47% loss. After gaining elbow extension, subjects in both groups rated the performance of most activities of daily living (ADL) and all self-selected activities as better, as measured on the Modified University of Minnesota Tendon Transfer Functional Improvement Questionnaire and the Canadian Occupational Performance Measure, respectively. This study concluded that restoration of elbow extension in individuals with tetraplegia is beneficial, and the biceps transfer is a good alternative to the deltoid-to-triceps transfer for those with good brachialis and supinator strength.

Keywords

elbow extension

deltoid to triceps transfer

biceps to triceps transfer

tetraplegia

spinal cord injuries

antigravity strength

elbow flexion torque

activities of daily living

Modified University of Minnesota Tendon Transfer Functional Improvement Questionnaire

Canadian Occupational Performance Measure