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Surgical techniques for reconstruction of chronic insufficiency of the triceps

ROTATION FLAP USING ANCONEUS AND TENDO ACHILLIS ALLOGRAFT

The Shoulder and Elbow Unit, Orthopaedic Surgery, Hospital La Paz, Madrid, Spain.

B. F. Morrey, MD, Professor, Emeritus Chair

Department of Orthopaedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.

Correspondence should be sent to Professor B. F. Morrey.

Seven patients with chronic insufficiency of the triceps were treated by either a rotation flap using anconeus (4) or an allograft of tendo Achillis (3). The latter procedure was selected for patients with a large defect in whom the anconeus muscle had been devitalised. Five disruptions were in patients who had previously undergone an elbow replacement. The patients were assessed for subjective satisfaction, pain, range of movement and strength, and the results were graded using the Mayo Elbow Performance Score (MEPS). The mean follow-up was for 33 months (9 to 63).

One rotation flap failed six months after operation. At the most recent follow-up, the remaining six patients had no or slight pain, restoration of a functional arc of movement and normal or slightly decreased power of extension. All six were satisfied with the outcome and were able to resume their daily activities with no limitations other than those imposed by the previous elbow replacement. The final MEPS was 100 points in five patients and 75 in one.

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