Blood supply of the upper extremity muscles as related to functional tendon transfers

For a given function to be restored, we feel that a "low risk" muscle should be employed in preference to a "high risk" muscle. If a "high risk" muscle must be used, a knowledge of its segmental blood supply should lead one to proceed with careful dissection (even under magnification), wider exposure, and preservation of every possible distal pedicle. We would strongly discourage blind "stripping" of the muscle belly in "high risk" muscles. This technique could be employed almost with impunity in the "low risk" muscles. We realize that this is a static, purely anatomic study with a new, theoretical viewpoint of tendon transfer techniques. Other factors must be considered (expendability, muscle strength, synergism, and amplitude). However, we feel that results may be improved through application of these detailed anatomic data. We have attempted to better delineate the blood supply to the muscles of the upper extremity. This knowledge may help improve our results in functional tendon transfer procedures.