Partial monopolar transfer of pectoralis major for elbow active flexion restoration in children with arthrogryposis
- Authors: Agranovich O.E.1, Petrova E.V.1, Batkin S.F.1, Ermolovich E.I.1, Komolkin I.A.2, Kenis V..1, Sapogovskiy A.V.1, Blagoveschenskiy E.D.1,3
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Affiliations:
- H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
- Saint Petersburg State Research Institute of Phthisiopulmonology
- National Research University “Higher School of Economics”
- Issue: Vol 9, No 4 (2021)
- Pages: 407-416
- Section: Original Study Article
- URL: https://journals.eco-vector.com/turner/article/view/79241
- DOI: https://doi.org/10.17816/PTORS79241
- ID: 79241
Cite item
Abstract
BACKGROUND: One of the main problems that limited or made the self-ability of patients with arthrogryposis impossible is the lack of active elbow flexion due to hypoplasia (or aplasia) of the forearm flexors and, especially the m. biceps brachii.
AIM: To evaluate the possibility of active forearm flexion restoration in children with arthrogryposis by partial monopolar transposition of the pectoralis major muscle.
MATERIALS AND METHODS: Elbow active flexion restoration by partial monopolar transposition of the pectoralis major muscle to biceps brachii was conducted in 34 children with arthrogryposis (39 upper limbs) from 2011 to 2020. The muscle autograft included a fragment of the fascia of the m. rectus abdominis. Clinical examinations of patients were performed before and after the operation. Statistical data processing was performed using the software packages Statistica 10 and SAS JMP 11.
RESULTS: The follow-up results were estimated from 6 to 99 months (44.53 ± 31.72) postoperative. The mean age of patients was 6.24 ± 4.24 years. The active postoperative elbow motion was 0°–120° (71.94 ± 33.40). The passive postoperative elbow motion did not change and was 90°–130° (104.12 ± 12.40). Muscles strength after the operation was grade 2–5. Elbow extension was limited in 30 cases (76.9%) from 0° to 40° (21.70 ± 12.27) without problem in the activities of daily living. Good results were determined in 15 cases (38.5%), satisfactory in 8 (20.5%), and poor in 16 (41%).
CONCLUSIONS: This study revealed that our partial monopolar transfer of pectoralis major to biceps brachii technic restored sufficient forearm flexion and improved self-ability without forming severe elbow flexor contractures of more than half of the patients with arthrogryposis.
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About the authors
Olga E. Agranovich
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
SPIN-code: 4393-3694
Scopus Author ID: 56913386600
http://www.rosturner.ru/kl10.htm
MD, PhD, D.Sc., head of the department of arthrogryposis, member of the Paediatric Hand International Society Of Surgeons (PHISOS), Federation of European Societies for Surgery of the Hand (FESSH), The International study group on arthrogryposis
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Ekaterina V. Petrova
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: pet_kitten@mail.ru
ORCID iD: 0000-0002-1596-3358
SPIN-code: 2492-1260
Scopus Author ID: 57194563255
MD, PhD
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Sergey F. Batkin
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: sergey-batkin@mail.ru
ORCID iD: 0000-0001-9992-8906
SPIN-code: 5173-9340
MD, orthopedic surgeon
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Evgeniya I. Ermolovich
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: dr.lazareva@bk.ru
ORCID iD: 0000-0001-6716-1034
SPIN-code: 6598-5653
MD, neurologist
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Igor A. Komolkin
Saint Petersburg State Research Institute of Phthisiopulmonology
Email: igor_komolkin@mail.ru
ORCID iD: 0000-0002-0021-9008
SPIN-code: 2024-2919
MD, PhD, D.Sc
Russian Federation, Saint PetersburgVladimir M. Kenis
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: kenis@mail.ru
ORCID iD: 0000-0002-7651-8485
SPIN-code: 5597-8832
Scopus Author ID: 36191914200
ResearcherId: K-8112-2013
MD, PhD, D.Sc., Professor
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Andrey V. Sapogovskiy
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: sapogovskiy@gmail.com
ORCID iD: 0000-0002-5762-4477
SPIN-code: 2068-2102
Scopus Author ID: 57193257532
MD, PhD
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603Evgeniy D. Blagoveschenskiy
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; National Research University “Higher School of Economics”
Author for correspondence.
Email: eblagovechensky@hse.ru
ORCID iD: 0000-0002-0955-6633
SPIN-code: 2811-5723
Scopus Author ID: 6506349269
ResearcherId: B-5037-2014
PhD
Russian Federation, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603; MoscowReferences
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