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Functional restoration in the upper extremity using free muscle transplantation
J C Grotting1, H J Buncke, W C Lineaweaver
1University of Alabama, Birmingham.
Annales De Chirurgie De La Main Et Du Membre Superieur : Organe Officiel Des Societes De Chirurgie De La Main = Annals of Hand and Upper Limb Surgery
|January 1, 1990
Summary
Free muscle transfers successfully restored upper limb function in patients unable to undergo simpler reconstructions. This surgical technique offers a feasible option for functional upper limb reconstruction, leading to high patient satisfaction.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Patients with significant upper limb functional loss, including finger flexion/extension and thumb opposition deficits, were evaluated.
- These patients were unsuitable for less complex reconstructive methods due to muscle weakness or traumatic loss of balancing musculature.
Observation:
- Fourteen free muscle transfers were performed in twelve patients over a follow-up period of one to nine years.
- All muscle transfers were technically successful without flap loss.
- Electromyography (EMG) indicated reinnervation starting around two months post-surgery, with progressive improvement over two to three years.
Findings:
- Eleven of the fourteen transferred muscles achieved movement against resistance.
- Two muscles regained movement against gravity, and one showed minimal motion.
- The procedure demonstrated technical feasibility and effectiveness in restoring function.
Implications:
- Free muscle transplantation is a viable surgical option for complex upper limb functional reconstruction.
- The technique offers a high degree of patient satisfaction for individuals with severe functional deficits.
- This approach expands reconstructive possibilities for patients with challenging upper limb injuries.