Abstract Six children between 7–16 years of age presented with flail shoulder and elbow caused by poliomyelitis. Shoulder fusion was followed by free-functioning gracilis transplantation to replace the atrophied biceps muscle. The transplanted muscle was reinnervated by either the spinal accessory or phrenic nerve. Follow-up averaged 44 months (range, 56–23 months). All cases developed at least grade 3 power of elbow flexion and were able to place their hands to their mouths. Five out of 6 cases were able to flex their ...