PMC5977047_01
Surgical findings of the modified SLM procedure (Case 1). Whole FCU and forearm flexor muscle groups are lifted with the bone fragment from the medial epicondyle of the humerus and are shifted to the central and radial sides of the humerus. Note the ulnar and median nerves (hidden) protected with a silicone tape.
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SLM procedure would provide good and stable results. Seven months following the injury, the modified SLM procedure was performed (Figure 2).
Excellent elbow flexion strength and range of motion at 10 months postoperatively (maximum range of elbow flexion, 140 ) in Case 1.
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With the arms hanging at the side, the patient's active range of elbow flexion was 0  preoperatively, which increased to 80  six months after the surgery and 140  ten months after the surgery (Figure 3).
The patient was able to carry a 5 kg object with both hands at 10 months postoperatively (Case 1).
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The patient was also able to carry a 5 kg object with both hands (Figure 4).
PMC5977047_02
The patient was able to extend the wrist during muscle training using a weight of 1 kg at 12 months postoperatively (Case 2).
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Since surgical reconstruction of elbow flexion was planned, the focus was on strengthening of the muscle groups involved in wrist flexion and extension (Figure 5).
Excellent elbow flexion strength and range of motion of elbow flexion at 6 months postoperatively (maximum range of elbow flexion, 120 ) in Case 2.
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At six months postoperatively, the patient achieved excellent elbow flexion strength (MMT 4), and the active range of elbow flexion increased from 0  preoperatively to 120  postoperatively (Figure 6).