Long Head of the Triceps Transfer to the Proximal Ulna for Active Elbow Flexion in Arthrogryposis

(1)Elbow flexion can be improved through long head of triceps transfer in children with amyoplastic type of arthrogryposis.(2)Use of one head of the triceps adds elbow flexion and does not sacrifice elbow extension function as the medial and lateral heads of the triceps are preserved as elbow extensors.(3)Most children with arthrogryposis have demonstrated clinically that they can achieve selective control of the long head of the triceps to flex the elbow post-operatively, while relaxing the medial and lateral heads of the triceps for elbow extension.(4)The long head of the triceps originates from the scapula and has separate radial nerve branch proximal innervation allowing dissection away from the other two heads of the triceps.(5)Careful dissection and understanding of the anatomy of the three heads of the triceps is needed for successful surgical transfer of the long head of the triceps.