title: Early results of anterior elbow release with and without biceps lengthening in patients with cerebral palsy.
abstract: OBJECTIVE
  To investigate the effect of partial biceps lengthening on elbow flexion posture and active elbow flexion and extension in patients with cerebral palsy.
  
  
  METHODS
  We retrospectively reviewed 29 patients with cerebral palsy who underwent anterior elbow release as part of multilevel upper extremity surgery. The early series of the patients (N = 14; group 1) had lacertus fibrosus division, brachialis fractional lengthening, and denuding of the pretendinous adventitia off the biceps tendon. The later series of patients (N = 15; group 2) had partial biceps tendon lengthening in addition to the procedures in group 1. We compared the 2 sets of patients for elbow flexion posture, active elbow flexion and extension, forearm rotation, and House scores, with mean follow-ups of 72 months for group 1 and 31 months for group 2.
  
  
  RESULTS
  The 2 groups were comparable in terms of mean age, number of procedures, and preoperative House scores. Group 2 patients had more improvement in flexion posture (53° vs. 44°) and active extension (23° vs. 15°) than group 1 postoperatively. However, group 2 had a mean decrease of 7° in active elbow flexion, whereas group 1 had no changes. There was no difference in forearm supination or in the improvement of House scores between groups.
  
  
  CONCLUSIONS
  Early results of partial lengthening of the biceps tendon showed that it may improve elbow flexion posture and active elbow extension in patients with flexion deformity in cerebral palsy.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; Albert Einstein College of Medicine, Bronx, NY; Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea. Electronic address: hsgong@snu.ac.kr.
authors.forename: Hyun Sik
authors.initials: HS
authors.lastname: Gong
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; Albert Einstein College of Medicine, Bronx, NY; Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hoyune Esther
authors.initials: HE
authors.lastname: Cho
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; Albert Einstein College of Medicine, Bronx, NY; Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Chin Youb
authors.initials: CY
authors.lastname: Chung
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; Albert Einstein College of Medicine, Bronx, NY; Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Moon Seok
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; Albert Einstein College of Medicine, Bronx, NY; Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyuk Jin
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; Albert Einstein College of Medicine, Bronx, NY; Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Baek
mesh_terms: D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000601:surgery*; D002648:Child; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000601:surgery; D011187:Posture; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cerebral palsy; anterior elbow release; biceps lengthening; flexion deformity