Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Elbow flexion
63%
4045/6407
Elbow extension
2%
142/6407
Shoulder external rotation
4%
254/6407
Shoulder adduction
12%
800/6407
Shoulder abduction
17%
1120/6407
Select Answer to see Preferred Response
During open pectoralis major tendon transfer for chronic subscapularis deficiency, the musculocutaneous nerve is most at risk. Injury to this nerve would lead to weakness in elbow flexion. Musculocutaneous nerve neurapraxia is a known complication of the procedure caused by increased tension on the nerve. The transferred tendon should be placed deep to the conjoint tendon, but superficial to the nerve to decrease tension. A proximal musculocutaneous nerve neurapraxia could cause weakness in elbow flexion, due to its innervation of the biceps and brachialis muscles. Klepps et al. performed a cadaveric study to examine the surgically relevant anatomy of subcoracoid pectoralis transfer. Transfer of the pectoralis major superficial to the musculocutaneous nerve created less tension than transfer deep to the musculocutaneous nerve. They concluded release of the proximal musculocutaneous branches, or debulking of the pectoralis major muscle belly may be required in some instances to prevent tension on the musculocutaneous nerve. Jost et al. found that in cases of irreparable subscapularis muscle function, pectoralis major transfer resulted in improvement for patients if they had an associated reparable supraspinatus tear. Patients with irreparable tears of both the subscapularis and supraspinatus had less favorable results. Illustration A shows a figure of pectoralis transfer for subscapularis insufficiency. The transferred tendon is placed deep to the conjoint tendon, but superficial to the musculocutaneous nerve to decrease tension. Incorrect Answers: Answer 2: Elbow extension (triceps) is from radial nerve. Answer 3: Shoulder external rotation (infraspinatus, teres minor) is from the suprascapular and axillary nerves, respectively. Answer 4: Shoulder adduction (pectoralis major, latissimus dorsi, teres major) is from the medial and lateral pectoral nerves, thoracodorsal nerve, and lower subscapular nerve. Answer 5: Shoulder abduction (supraspinatus, deltoid) is from the suprascapular and axillary nerves.
4.2
(25)
Please Login to add comment