Restoring elbow flexion by pectoralis major transplantation in war-injured patients.

In seven war victim patients, five with brachial plexus palsy, one with biceps brachii muscle loss and one with pure injury of the musculo-cutaneous nerve and atrophic muscle, we modified Carroll and Kleinman's original pectoralis major muscle technique and then adopted it for use in all seven patients to restore elbow flexion (Carroll and Kleinman, Journal of Hand Surgery, 4:501, 1979). The entire pectoralis major muscle with the rectus sheath was transplanted to the tendon of the biceps near the insertion. Motion and power were well restored in five patients, satisfactorily in one patient, and unknown in the other case because the patient was lost to follow-up.