[Effect of brachial-radial and extensor carpi radialis longus tenodesis on elbow flexion-extension movements. Application to tendon transfers in tetraplegia].

The authors show that extension of the elbow produces a traction on brachioradialis (BR) and extensor carpi radialis longus (ECRL): if their tendon is distally freed, it is pulled in the proximal direction when the elbow extends. This phenomenon provides tenodesis effects, especially after tendon transfer in tetraplegia. It has been assessed on 31 upper limbs of patients and fresh cadavers. The mean tendon excursion, between 90 degrees flexion and full extension of the elbow, was 32 mm for BR and 19 mm for ECRL. These tenodesis effects related to the extension of the elbow leads the authors to recommend three practices in tetraplegic patients: active extension of the elbow should be restored before rehabilitation of the hand, and a 90 degrees flexion of the elbow is the position in which BR and ECRL transfers should be set intraoperatively, as well as immobilized postoperatively.