Brooks-Seddon transfer of pectoralis major tendon for paralysis of elbow flexors. A, Insertion of pectoralis major is detached as close to bone as possible. B, Tendon of long head of biceps is exposed and divided at proximal end of bicipital groove. C, Tendon and muscle of long head of biceps are completely mobilized distally to tuberosity of radius by dividing all vessels and nerves that enter muscle proximal to elbow. D, Long head of biceps is passed through two slits in pectoralis major, is looped on itself so that its proximal tendon is brought into distal incision, and is sutured through slit in its distal tendon. E, To avoid undesirable movements of shoulder during elbow flexion after this transfer, muscular control of shoulder and scapula must be good, or shoulder must be fused. Left shoulder shown is flail; right has been fused. When transfer on left contracts, some of its force is wasted because of lack of control of shoulder, but, on right, transfer moves only elbow. SEE TECHNIQUE 34.27.