Résumé
Introduction: Morbidity is considered to be negligible in Leechavengvongs transfer (LT) of the long head of the triceps onto the axillary nerve, but the assessment methods used may lack reproducibility. We assessed triceps strength after LT objectively by the isokinetic technique, addressing the following questions: Is strength lowered after LT compared to the healthy limb? And 2) is there a good correlation between isokinetic dynamometry and subjective assessment? Hypothesis: Isokinetic measurement shows a decrease in triceps strength at peak torque after LT com-pared to the healthy limb, and this morbidity is underestimated on subjective assessment. Material and methods: This single-center retrospective study included patients undergoing LT for axillary nerve trunk palsy between 2008 and 2020, with M5 triceps preoperatively on the British Medical Research Council (BMRC) scale. Twenty patients, with a mean age of 25 +/-; 9 years (range, 15-48 years) were assessed at a mean 58 +/- 47 months (range, 6-174 months). Elbow extension strength was assessed on a standardized questionnaire, BMRC isometric test and isokinetic test on an angular course of 90 at 60/sec and 180/sec concentrically and 30/sec excentrically. Results: Strength at 60/sec and 180/sec concentrically and 30/sec excentrically was significantly lower than in the healthy limb: respectively, -17 Nm, -15 Nm, and -16 Nm, (p < 0.001) for a mean -23%. Loss of strength was mainly severe on isokinetic testing and mild on isometric testing. Seven patients reported contracture (35%), 12 fatigue (60%), and 3 weakness (15%). Satisfaction with extension strength was excellent or good for respectively 12 (60%) and 8 patients (40%). Triceps strength was graded BMRC M4 in 9 triceps (11%) and M5 in 11 (55%). Discussion: After LT, isokinetic measurement found generally severe loss of triceps strength, but without subjective impact on everyday life. Level of evidence: IV; retrospective study. (c) 2022 Elsevier Masson SAS. All rights reserved.