LONG-TERM RESULTS OF THE STEINDLER FLEXORPLASTY

Seventy-one consecutive patients were treated with a modified Steindle r flexorplasty from 1970 to 1987. The mechanisms of injury and etiolog ies included 45 motor vehicle accidents, 13 birth injuries, and 13 cas es of poliomyelitis. Additional operative procedures included shoulder fusion (45 patients), tendon transfer (20 patients), and wrist tenode sis (3). Follow-up averaged 8.2 years. The outcome was excellent in 32 %, good in 47%, fair in 13%, and poor in 8%. Postoperatively, the mean arc of active elbow flexion was 114-degrees; the average elbow extens ion loss, 28-degrees; the mean active pronation, 74-degrees; and supin ation, 30-degrees. Wire breakage was found in two cases. Additional te ndon transfer of flexor carpi ulnaris to extensor carpi radialis brevi s improved the outcomes in the patients without active supination. The modified Steindler flexorplasty provided predictable functional impro vement in carefully selected patients with paralyzed upper extremities .