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Vakhshori et al. Plast Aesthet Res 2023;10:36 Plastic and
DOI: 10.20517/2347-9264.2022.78
Aesthetic Research

Review Open Access

Functional muscle transfer for restoration of elbow
flexion: a review

Venus Vakhshori, Ali Azad

Department of Orthopaedic Surgery, New York University, New York, NY 10016, USA.
Correspondence to: Dr. Ali Azad, Department of Orthopaedic Surgery, New York University, 301 East 17th Street, New York, NY
10016, USA. E-mail: ali.azad@nyulangone.org

How to cite this article: Vakhshori V, Azad A. Functional muscle transfer for restoration of elbow flexion: a review. Plast Aesthet
Res 2023;10:36. https://dx.doi.org/10.20517/2347-9264.2022.78
Received: 13 Jul 2022 Revised: 30 Apr 2023 First Decision: 16 Jun 2023 Accepted: 3 Jul 2023 Published: 7 Jul 2023

Academic Editors: Matthew Iorio, Harvey Chim, Jacques Henri Hacquebord Copy Editor: Yanbing Bai Production Editor:
Yanbing Bai

Abstract
Elbow flexion is essential to help position the hand in space and for functional use of the upper extremity. Loss of
elbow function can be secondary to many etiologies, including but not limited to brachial plexus injury, traumatic
muscle loss, oncologic treatment, poliomyelitis or congenital absence of motor function. The end result is a
significant functional limitation of the upper extremity. One method to address the loss of elbow flexion is the use
of a functional muscle transfer. These transfers can be performed as pedicled rotational transfers or free functional
muscle transfers. This article reviews functional muscle transfers for restoration of elbow flexion as a treatment
option for patients with an otherwise unreconstructable extremity.

Keywords: Brachial plexus injury, elbow flexion, functional muscle transfer, pedicled latissimus dorsi transfer, free
latissimus dorsi transfer, free gracilis transfer

INTRODUCTION
Elbow flexion is considered one of the most important upper extremity motions to accomplish activities of
daily living. As such, loss of elbow flexion significantly limits upper extremity function. These injuries may
be caused by obstetric or traumatic brachial plexus injuries, elbow flexor muscle loss due to trauma or
oncologic resection, brachial plexus damage from oncologic resection or radiation treatment, poliomyelitis,

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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