Importance of the Wrist Extensor Muscle Training: Two Cases of Elbow Flexorplasty following Traumatic Brachial Plexus Injuries

Figure 1

Modification of the Steindler–Leo Mayer procedure (modified SLM procedure) [7]. The flexor-pronator muscle group of the forearm was lifted with the neurovascular bundle along with a bone fragment from the medial epicondyle of the humerus and shifted 8–10 cm to the central and radial sides to act as the primary source of power for elbow flexion. We modified the Leo Mayer procedure to improve the muscle strength further, and not only the humeral head of the FCU but also the ulnar head was detached from the olecranon with the neurovascular bundle. This figure was reprinted from reference [7] by permission of Nankodo Co., Ltd. UN: ulnar nerve; MN: median nerve; A: brachial artery; MEC: cut end of the medial epicondyle; FCU: entire flexor carpi ulnaris muscle and forearm flexor muscle groups; BA: bare area of the ulna after ulnar head of the FCU was mobilized.