Modified transfer of the pectoralis major muscle for restoration of elbow flexion in facioscapulohumeral muscular dystrophy: A case report

Abstract

Background: Facioscapulohumeral muscular dystrophy (FSHD) is the third most common form of muscular dystrophy. It primarily exhibits slowly progressing symmetric muscle weakness in the facial, scapular, and upper arm muscles. The loss of elbow flexion is the most debilitating impairment for daily activities such as eating, grooming, and work-related tasks. The restoration of elbow flexion is more critical than any other functional recovery. Case report: We present case of a 41-year-old male patient with non-functioning elbow flexion due to FSHD. The authors selected the pectoralis major muscle as the donor muscle through preoperative electromyographic and clinical examinations. The authors opted for the modified pectoralis major transfer method, connecting the distal tendon of the pectoralis major to the proximal tendon of the biceps brachii, to minimize surgical risks through a minimal approach. By the 3 months after the surgery, the patient demonstrated the ability to perform active elbow flexion. Conclusion: For performing elbow flexoplasty in FSHD patients, it is essential to conduct thorough electromyographic and clinical examinations prior to surgery to accurately select the donor muscle. Additionally, the use of modified pectoralis major transfer for flexoplasty is considered a simple and safe surgical technique, offering the potential for favorable outcomes.

Keywords

• Muscular dystrophy
• Biceps
• Pectoralis
• Transfer