Arthrogryposis Elbow Extension Contracture

Children with arthrogryposis commonly lack passive and active elbow flexion. Giving these children at least passive flexion can be life changing, with gains in self-feeding, grooming, and other activities of daily living. Often, it can make the difference between lifelong dependence on caretakers and independence. Posterior elbow release, triceps lengthening, and ulnar nerve transposition have become the standard of care for achieving passive elbow flexion. Previous attempts to reroute the entire triceps to provide active flexion yielded in fixed elbow flexion deformities and loss of perineal self-care. Active elbow flexion can most reliably be achieved via a bipolar latissimus dorsi muscle transfer at a later age, provided that the muscle is adequate for transfer.