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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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Free Functional Muscle Transfer for Thumb Opposition.

Alexander Seal1, Milan Stevanovic2

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Summary

Free functional muscle reconstruction using the serratus anterior muscle effectively restored thumb opposition and grip strength after thenar loss. This surgical technique offers a promising solution for significant hand function limitations.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Microsurgery

Background:

  • Thenar muscle loss due to traumatic injuries results in significant functional deficits, including impaired thumb opposition and grip strength.
  • Limited reconstructive options exist for restoring both the function and bulk of the thenar musculature.
  • Thumb opposition is crucial for hand function, impacting activities of daily living and vocational tasks.

Observation:

  • A 26-year-old male sustained a crush injury to his left hand, leading to the loss of thenar muscles and opposition.
  • The patient experienced persistent difficulties with grasp and object manipulation due to the loss of thenar function and bulk.
  • A free functional muscle transfer using the serratus anterior muscle was performed for reconstruction.

Findings:

  • The patient achieved excellent outcomes following the serratus anterior free functional muscle transfer.
  • Restoration of active thumb opposition and significant improvement in grip strength were observed.
  • Both the functional deficit and the aesthetic loss of bulk in the thenar region were successfully addressed.

Implications:

  • The serratus anterior muscle is a viable and effective donor for reconstructing thumb opposition.
  • This case highlights the potential of free functional muscle transfer to restore complex hand functions after severe trauma.
  • The described technique offers a valuable option for improving quality of life and restoring vocational capacity in patients with thenar defects.