Restoration of Elbow Flexion With a Free Functional Gracilis Muscle Transfer in an Arthrogrypotic Patient Using a Motor Nerve to Pectoralis Major.

Abstract

<b>Background:</b> Patients with arthrogryposis may exhibit inability to flex the elbow. A free functional gracilis muscle transfer (FFGMT) can be used to restore elbow flexion. In our search of the available literature, we have not seen any descriptions of using a motor branch to the pectoralis major as a donor nerve to establish elbow flexion. <b>Methods:</b> We performed an FFGMT for restoration of elbow flexion in an arthrogrypotic patient with no active elbow flexion, who had a Medical Research Council (MRC) muscle grade of 0. <b>Results:</b> We report our 4.5-year outcomes. After undergoing an FFGMT for elbow flexion, our patient was able to gain an MRC grade 4 and achieve an arc of motion of 25° to 140°. <b>Conclusion:</b> An FFGMT for elbow flexion may be performed successfully using a motor branch to the pectoralis major.