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Free functioning muscle transfer for lower extremity posttraumatic composite structure and functional defect.

Chih-Hung Lin1, Yu-Te Lin, Jiun-Ting Yeh

  • 1Taipei, Taiwan From the Division of Trauma, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University.

Plastic and Reconstructive Surgery
|May 24, 2007
PubMed
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Free functioning muscle transfer effectively restores function and saves limbs in lower extremity trauma patients with extensive soft-tissue and muscle loss. This surgical technique offers reliable limb salvage and acceptable functional outcomes.

Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery
  • Trauma Surgery

Background:

  • Lower extremity trauma often involves extensive soft-tissue defects and loss of flexor/extensor muscles.
  • Free functioning muscle transfer is a reconstructive option for restoring both structure and function.

Purpose of the Study:

  • To evaluate the efficacy of free functioning muscle transfer in patients with severe lower extremity trauma.
  • To assess limb salvage rates and functional outcomes following this reconstructive procedure.

Main Methods:

  • A cohort of 19 patients with severe lower extremity injuries (open fractures, compartment syndromes, crush injuries) underwent free functioning muscle transfer.
  • Various muscle sources, including rectus femoris and gracilis, were utilized, sometimes with composite tissue transfers for defect reconstruction.

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Main Results:

  • Successful limb salvage was achieved in most cases, though two patients required reexploration and one amputation.
  • Functional outcomes varied, with some patients experiencing reinnervation failure requiring ankle fusion or bracing.
  • Poorer functional results were noted in patients with compartment syndromes.

Conclusions:

  • Free functioning muscle transfer is a viable post-traumatic reconstructive option for lower limbs with combined soft-tissue and motor-unit defects.
  • The procedure can lead to acceptable functional results and reliable limb salvage in carefully selected patients.