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FLEXORPLASTY OF THE ELBOW An Evaluation of a Method
Robert E. Carroll; John J. Gartland
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New York Orthopardic Hospital at the Columbia-Presbyterian Medical Center, New York
1953 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1953; 35:706-710 
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Abstract

In reviewing the results in twenty-seven flexorplasties, the authors were impressed with the value of the operation. When at all possible, it is greatly to be preferred to other methods of restoring active flexion to the elbow.

A fixed flexion deformity of about 40 degrees should be expected. It is a functional position. There should be no hesitation from the viewpoint of appearance, for this angle does not constitute a cosmetic defect.

A tendency toward a pronated position of the forearm should be expected. If the supinators are strong, there will be balance. Insertion of the transplanted flexor mass into a more anterior position on the humerus was found to be an aid in diminishing this tendency. The use of the flexor carpi ulnaris as a supinator is also a method of preventing forearm pronation.

Great care must be given to evaluating the power of the flexor-pronator group of muscles prior to operation. The power located in the superficial flexor mass of the forearm is the most important. The power of these muscles is increased by arthrodesis of the wrist.

Knowledge of the technique of this operation should be exact. Adequate distal mobilization along the superficial flexor-muscle mass is most important. The adjacent nerves must be protected. The mass should be transplanted proximally and anteriorly on the humeral shaft. Secure fixation to the new site is mandatory. Utilization of cortical defects, such as drill holes, is helpful in achieving this fixation.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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