Pediatric Traumatology, Orthopaedics and Reconstructive SurgeryPediatric Traumatology, Orthopaedics and Reconstructive Surgery2309-39942410-8731Eco-Vector7924110.17816/PTORS79241Research ArticlePartial monopolar transfer of pectoralis major for elbow active flexion restoration in children with arthrogryposisAgranovichOlga E.<p><span lang="EN-US">MD, PhD, </span>D.Sc., <span lang="EN-US">head of the department of arthrogryposis, </span>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</p>olga_agranovich@yahoo.comhttps://orcid.org/0000-0002-6655-4108PetrovaEkaterina V.<p>MD, PhD</p>pet_kitten@mail.ruhttps://orcid.org/0000-0002-1596-3358BatkinSergey F.<p>MD, orthopedic surgeon</p>sergey-batkin@mail.ruhttps://orcid.org/0000-0001-9992-8906ErmolovichEvgeniya I.<p>MD, neurologist</p>dr.lazareva@bk.ruhttps://orcid.org/0000-0001-6716-1034KomolkinIgor A.<p>MD, PhD, D.Sc</p>igor_komolkin@mail.ruhttps://orcid.org/0000-0002-0021-9008KenisVladimir M.<p>MD, PhD, D.Sc., Professor</p>kenis@mail.ruhttps://orcid.org/0000-0002-7651-8485SapogovskiyAndrey V.<p>MD, PhD</p>sapogovskiy@gmail.comhttps://orcid.org/0000-0002-5762-4477BlagoveschenskiyEvgeniy D.<p>PhD</p>eblagovechensky@hse.ruhttps://orcid.org/0000-0002-0955-6633H. Turner National Medical Research Center for Children’s Orthopedics and Trauma SurgerySaint Petersburg State Research Institute of PhthisiopulmonologyNational Research University “Higher School of Economics”15122021944074162708202122112021Copyright © 2021, Agranovich O.E., Petrova E.V., Batkin S.F., Ermolovich E.I., Komolkin I.A., Kenis V. ., Sapogovskiy A.V., Blagoveschenskiy E.D.2021<p><strong><em>BACKGROUND</em></strong><strong><em>:</em></strong> 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.</p>
<p><strong><em>AIM: </em></strong>To evaluate the possibility of active forearm flexion restoration in children with arthrogryposis by partial monopolar transposition of the pectoralis major muscle.</p>
<p><strong><em>MATERIALS AND METHODS: </em></strong>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.</p>
<p><strong><em>RESULTS: </em></strong>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 0120 (71.94 33.40). The passive postoperative elbow motion did not change and was 90130 (104.12 12.40). Muscles strength after the operation was grade 25. 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%).</p>
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