title: A biomechanical study of a suture between the deltoid muscle and a free tendon graft for reconstruction of the elbow extension.
abstract: OBJECTIVE
  It is possible to reconstruct the elbow motion in tetraplegic patients using the posterior portion of the deltoid muscle. In this surgery however, it is a problem to achieve a firm suture between the deltoid muscle and the tendon graft which extends the muscle and is sewn in order to compensate for the plegic musculus triceps brachii function. This study assesses two methods of attachment between muscle and free tendon graft from the biomechanical point of view.
  
  
  METHODS
  The assessment was made on 7 fresh-frozen cadaveric samples where the rear portion of the deltoid muscle was sewn with the strip of fascia lata (A1-A7) and 7 samples (B1-B7) where the free tendon graft was attached with a strengthened part of deltoid fascia. The character of the attachment defect was evaluated as strength and elongation parameters using the device Zwick Z020-TND.
  
  
  RESULTS
  The ANOVA showed a statistically significant greater suture solidity connecting the muscle and tendon for group B (B1-B7) than group A. The deformation of the actual suture location was smaller in group B than the deformation of attachment surroundings.
  
  
  CONCLUSIONS
  From the biomechanical solidity point of view, it is more efficient to use the strengthened fascia of the deltoid muscle on its inner side for the suture with the tendon graft for reconstruction of the elbow extension in tetraplegic patients.
authors.affiliation: Department of Traumatology, University Hospital Olomouc, Czech Republic. i.cizmar@seznam.cz
authors.forename: Igor
authors.initials: I
authors.lastname: Cizmar
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Florian
authors.forename: Tomas
authors.initials: T
authors.lastname: Navrat
authors.forename: David
authors.initials: D
authors.lastname: Palousek
mesh_terms: D001178:Arthroplasty; D002102:Cadaver; D057645:Deltoid Muscle / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D011782:Quadriplegia / Q000601:surgery; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*