The Journal of Bone and Joint Surgery, Vol 62, Issue 1 108-112, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Musculocutaneous neurectomy for spastic elbow flexion in non-functional upper extremities in adults
DE Garland, R Thompson and RL Waters
The charts of twenty-nine patients who had undergone thirty
musculocutaneous neurectomies for acquired spasticity of the elbow in a
non-functional upper extremity were reviewed. The most common causes of the
spasticity were cerebrovascular accident (59 per cent) and head injury (24
per cent). The aims of the operation were to increase the patient's
capacity for self-care and to improve ambulation, personal hygiene, and
appearance. Patients who had 30-degree flexion contractures preoperatively
did not require a cast postoperatively; those who had 30 to 75-degree
flexion contractures preoperatively required a cast postoperatively; and
patients who had flexion contractures of more than 75 degrees
preoperatively required a concomitant release of soft tissue in the elbow
and application of a cast postoperatively. One patient who was operated on
to improve appearance had no active elbow flexion postoperatively and was
regarded as having a poor result. Musculocutaneous neurectomy is a safe,
reliable procedure for treating the spastic elbow in the non-functional
upper extremity.
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