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Triceps to biceps transfer to restore elbow flexion in biceps paralysis



Achievement of active elbow flexion through transfer of a functional triceps muscle to the paralyzed biceps muscle.


Loss of or insufficient function of the elbow flexors.

Impossibility of active elbow flexion due to a simultaneous contraction of triceps and biceps muscles in instances of plexus injuries.

Loss of elbow flexion due to peripheral nerve lesions and poliomyelitis.


Insufficient rehabilitation following neurosurgical procedures.

Insufficient power of the triceps muscle (exception: simultaneous contraction with biceps muscle).

Insufficient passive range of motion of elbow (posttraumatic or degenerative changes).

Surgical Technique

The tendon of the triceps muscle is detached from the olecranon and rerouted around the lateral border of the humerus to the anterior side. The triceps tendon is inserted into a slot of the biceps tendon close to its insertion and sutured.


The transfer of the triceps muscle to the tendon of the biceps muscle in 3 patients with active loss of elbow flexion resulted in an adequate active elbow flexion (>90°), a satisfactory range of motion and a good power (at least flexion against gravity). No complications were recorded.

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Correspondence to Frank Gossé.

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Rühmann, O., Wirth, C.J. & Gossé, F. Triceps to biceps transfer to restore elbow flexion in biceps paralysis. Orthop Traumatol 7, 87–94 (1999). https://doi.org/10.1007/BF03180925

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Key Words

  • Triceps to biceps transfer
  • Brachial plexus palsy
  • Biceps paralysis