Atkins R M, Bell M J, Sharrard W J
J Bone Joint Surg Br. 1985 Aug;67(4):640-4. doi: 10.1302/0301-620X.67B4.4030867.
Seven pectoralis major transfers in children suffering from bilateral paralysis of elbow flexion due to arthrogryposis or to trauma are reported. A technique is described in which the muscle is mobilised from the clavicle to allow the tendon of insertion to be attached to the biceps tendon at the elbow. The biceps tendon was found to be present and could be mobilised forwards in all the arthrogrypotic elbows. Subjectively, the results were considered by patients or parents to be very good in six cases and fair in one. Elbow flexion power against gravity and against some resistance was achieved in all patients except one. The overall function was very good in one elbow, good in two, fair in three and poor in only one. The merits of the various procedures described for the restoration of elbow flexion in arthrogryposis are discussed. It is concluded that total pectoralis major transfer by the method described here has given the best results.
本文报告了7例因关节挛缩症或创伤导致双侧肘屈曲麻痹儿童的胸大肌转移术。文中描述了一种技术，即从锁骨处游离胸大肌，使胸大肌的止点肌腱附着于肘部的肱二头肌肌腱。结果发现，在所有关节挛缩症患儿的肘部，肱二头肌肌腱均存在且可向前游离。主观上，患者或家长认为6例效果非常好，1例效果尚可。除1例患者外，所有患者均实现了抗重力及一定阻力的肘屈曲力量。整体功能方面，1例肘部非常好，2例良好，3例尚可，仅1例较差。文中讨论了关节挛缩症中恢复肘屈曲的各种手术方法的优缺点。得出的结论是，采用本文所述方法进行的胸大肌完全转移术效果最佳。
