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Related Experiment Videos

Functional gracilis flap in thenar reconstruction.

P A Baker1, S B Watson

  • 1Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|April 24, 2007
PubMed
Summary
This summary is machine-generated.

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Free functional gracilis flaps successfully restored thumb opposition and thenar bulk in two patients with severe soft tissue defects. This single-stage procedure offers excellent functional recovery and minimal donor site morbidity.

Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Reconstructive Surgery

Background:

  • Restoring thumb opposition after significant thenar soft tissue defects is a major reconstructive challenge.
  • Free functioning muscle transfer offers a single-stage solution for both muscle function and soft tissue coverage.
  • Previous methods faced challenges like difficult dissections, donor site morbidity, and inadequate muscle function.

Observation:

  • This study presents two unique cases of functional thenar reconstruction using a free innervated gracilis muscle flap.
  • The recurrent motor branch of the median nerve was destroyed in both cases, necessitating innovative nerve coaptation.
  • The gracilis muscle was raised on its proximal neurovascular pedicle, with microvascular anastomosis to the radial artery and epineural anastomosis to the median nerve's recurrent motor branch.

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Findings:

  • Both free functional gracilis flaps survived without complications, leading to excellent voluntary thumb opposition.
  • Patients regained sufficient thenar bulk and function, enabling a return to full-time employment.
  • The procedure resulted in minimal donor site morbidity.

Implications:

  • Free functional gracilis flaps are a viable and effective option for reconstructing significant thenar defects.
  • This technique provides excellent functional and aesthetic outcomes in a single-stage procedure.
  • The versatility of the gracilis muscle in functioning free muscle transfer is highlighted by this novel application.