title: Biceps to Triceps Transfer in Tetraplegic Patients: Our Experience and Review of the Literature.
abstract: Background:Management and indications for surgery in the tetraplegic patient are highly complex because of the substantial functional deficits that they present and their effect on their daily activity. Our purpose was to evaluate the functional outcome in tetraplegic patients who underwent biceps-to-triceps transfer surgery according to Zancolli's modified technique.Methods:This is a retrospective study of 6 biceps-to-triceps transfers using Zancolli's modified technique in 4 patients. Mean follow-up was 45 months. We evaluated each patient's DASH (Disabilities of the Arm, Shoulder and Hand) score before surgery and 12 months later.Results:In the 6 arms that underwent surgery, full and active elbow extension against gravity at 12 months after surgery was achieved. The mean DASH score was 73.2 preoperatively and 20.8 twelve months postoperatively. One complication occurred. One patient reported loss of elbow flexion preventing thigh lift for transfers. This was resolved with a program of rehabilitation and specific muscle strengtheningConclusions:Zancolli's modified technique is simple and effective, with few complications, whereby we can provide more autonomy for the tetraplegic patient.
authors.affiliation: Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Medina
authors.affiliation: Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Marcos-García
authors.affiliation: Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Isidro
authors.initials: I
authors.lastname: Jiménez
authors.affiliation: Unit of Hand, Upper Limb and Peripheral Nerve, Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Muratore
authors.affiliation: Unit of Spinal Cord Injury, Department of Rehabilitation, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Méndez-Suárez
mesh_terms: D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000637:transplantation*; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications; D013709:Tendon Transfer / Q000379:methods*
keywords: Zancolli; elbow; extension; tendon; tetraplegia; transfer