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Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports
BACKGROUND: We report two cases of biceps brachii and brachialis paralysis due to musculocutaneous nerve injury in which elbow joint flexion was reconstructed using rotational transfer of the latissimus dorsi muscle with sutures to the radial and ulnar tuberosities, thereby enabling flexion by simul...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617077/ https://www.ncbi.nlm.nih.gov/pubmed/37904251 http://dx.doi.org/10.1186/s13256-023-04178-4 |
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author | Kobayashi, Yuka Uchiyama, Yoshiyasu Yoshida, Shinji Saito, Ikuo Ishii, Takayuki Nakajima, Daisuke Yanagisawa, Shou Watanabe, Masahiko |
author_facet | Kobayashi, Yuka Uchiyama, Yoshiyasu Yoshida, Shinji Saito, Ikuo Ishii, Takayuki Nakajima, Daisuke Yanagisawa, Shou Watanabe, Masahiko |
author_sort | Kobayashi, Yuka |
collection | PubMed |
description | BACKGROUND: We report two cases of biceps brachii and brachialis paralysis due to musculocutaneous nerve injury in which elbow joint flexion was reconstructed using rotational transfer of the latissimus dorsi muscle with sutures to the radial and ulnar tuberosities, thereby enabling flexion by simultaneous activation of the humeroradial and humeroulnar joints. In cases of associated brachialis paralysis, weaker flexion strength can be expected when the forearm is in a pronated position than when it is in a supinated state. To the best of our knowledge, no previous study has reported the rotational position of the forearm during elbow joint flexion reconstruction. CASE PRESENTATION: Case 1 involved a 30-year-old Asian male who presented with a rupture of the musculocutaneous, median, radial, and ulnar nerves. Reconstruction was performed by rotational transfer of the latissimus dorsi muscle. In this case, the supination and pronation flexion forces were equal. Case 2 involved a 50-year-old Asian man who presented with partial loss of the musculocutaneous nerve, biceps brachii, and pectoralis major due to debridement. Reconstruction was performed by rotational transfer of the latissimus dorsi muscle. In this case, supination and pronation flexion strengths were demonstrated to be equal. Our reconstruction method used the rotational transfer of the latissimus dorsi muscle; the distal muscle flap was divided into radial and ulnar sides to allow elbow joint flexion by simultaneously activating the humeroradial and humeroulnar joints. These sides were then fixed to the anchors at the radial and ulnar tuberosities. Finally, they were wrapped around the myotendinous junction of the biceps brachii or brachialis and secured using sutures. CONCLUSIONS: Although larger studies are required to verify these methods, this case study successfully demonstrates the following: (1) the flexion strength in the supinated position was equal to that in the pronated position; (2) the stability of the humeroradial and humeroulnar joints was unaffected by the forearm's rotational position; and (3) a satisfactory range of motion of the elbow joint was obtained, with no complications. |
format | Online Article Text |
id | pubmed-10617077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106170772023-11-01 Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports Kobayashi, Yuka Uchiyama, Yoshiyasu Yoshida, Shinji Saito, Ikuo Ishii, Takayuki Nakajima, Daisuke Yanagisawa, Shou Watanabe, Masahiko J Med Case Rep Case Report BACKGROUND: We report two cases of biceps brachii and brachialis paralysis due to musculocutaneous nerve injury in which elbow joint flexion was reconstructed using rotational transfer of the latissimus dorsi muscle with sutures to the radial and ulnar tuberosities, thereby enabling flexion by simultaneous activation of the humeroradial and humeroulnar joints. In cases of associated brachialis paralysis, weaker flexion strength can be expected when the forearm is in a pronated position than when it is in a supinated state. To the best of our knowledge, no previous study has reported the rotational position of the forearm during elbow joint flexion reconstruction. CASE PRESENTATION: Case 1 involved a 30-year-old Asian male who presented with a rupture of the musculocutaneous, median, radial, and ulnar nerves. Reconstruction was performed by rotational transfer of the latissimus dorsi muscle. In this case, the supination and pronation flexion forces were equal. Case 2 involved a 50-year-old Asian man who presented with partial loss of the musculocutaneous nerve, biceps brachii, and pectoralis major due to debridement. Reconstruction was performed by rotational transfer of the latissimus dorsi muscle. In this case, supination and pronation flexion strengths were demonstrated to be equal. Our reconstruction method used the rotational transfer of the latissimus dorsi muscle; the distal muscle flap was divided into radial and ulnar sides to allow elbow joint flexion by simultaneously activating the humeroradial and humeroulnar joints. These sides were then fixed to the anchors at the radial and ulnar tuberosities. Finally, they were wrapped around the myotendinous junction of the biceps brachii or brachialis and secured using sutures. CONCLUSIONS: Although larger studies are required to verify these methods, this case study successfully demonstrates the following: (1) the flexion strength in the supinated position was equal to that in the pronated position; (2) the stability of the humeroradial and humeroulnar joints was unaffected by the forearm's rotational position; and (3) a satisfactory range of motion of the elbow joint was obtained, with no complications. BioMed Central 2023-10-31 /pmc/articles/PMC10617077/ /pubmed/37904251 http://dx.doi.org/10.1186/s13256-023-04178-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Kobayashi, Yuka Uchiyama, Yoshiyasu Yoshida, Shinji Saito, Ikuo Ishii, Takayuki Nakajima, Daisuke Yanagisawa, Shou Watanabe, Masahiko Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
title | Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
title_full | Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
title_fullStr | Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
title_full_unstemmed | Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
title_short | Functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
title_sort | functional reconstruction of elbow flexion with latissimus dorsi muscle rotational transfer: two case reports |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617077/ https://www.ncbi.nlm.nih.gov/pubmed/37904251 http://dx.doi.org/10.1186/s13256-023-04178-4 |
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