A preliminary report of lower trapezius muscle transfer for elbow extension in children with brachial plexus birth injury (BPBI)

Elbow extension is crucial for daily activities but is often neglected in the context of brachial plexus injuries. Triceps palsy in children with brachial plexus birth injury (BPBI) can lead to significant functional impairments, including difficulty with overhead activities, stabilizing the arm, and performing tasks that require elbow extension. This cohort study included 12 children with BPBI who underwent lower trapezius to triceps transfer for elbow extension. Patients were followed for 6 months to 2 years postoperatively. Manual muscle testing using Lovett and Sunderland's method was performed preoperatively and postoperatively. Statistical analysis, including the Wilcoxon signed-rank test, was used to compare muscle strength before and after surgery, with a significance level of P < .05. Muscle power increased significantly from 1.33 (1) to 4.41 (1) with P < .001. No one developed weakness in elbow flexion; in all cases, elbow flexion-extension motion could be actively done. Lower trapezius-to-triceps transfer could be a promising surgical method for restoring elbow extension in children with BPBI.