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Functioning free muscle transplantation.

R T Manktelow, R M Zuker, N H McKee

    The Journal of Hand Surgery
    |January 1, 1984
    PubMed
    Summary
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    Free muscle transplantation to the extremity is a feasible surgical option for restoring finger flexion. This technique, when combined with precise nerve repair and optimal muscle placement, yields useful function and range of motion in most patients.

    Area of Science:

    • Microsurgery
    • Reconstructive Surgery
    • Orthopedic Surgery

    Background:

    • Free muscle transplantation is a complex reconstructive procedure.
    • Restoring function after loss of flexor musculature in the forearm presents challenges.
    • Tendon transfer may not always be a suitable or available option.

    Purpose of the Study:

    • To evaluate the long-term outcomes of free muscle transplantation to the forearm.
    • To identify critical surgical factors for successful muscle transplantation.
    • To assess the functional recovery, including range of motion and grip strength, after the procedure.

    Main Methods:

    • The study involved 12 cases of free muscle transplantation to the forearm.
    • Procedures utilized microvascular anastomosis for blood supply and fascicular nerve repair for innervation.

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  • Key surgical considerations included precise nerve repair and optimal muscle placement at tension.
  • Main Results:

    • Eleven out of 12 transplanted muscles survived completely.
    • Useful function was achieved in all surviving cases.
    • Nine patients regained a full range of finger motion.
    • Maximum grip strength achieved was 50% of normal.

    Conclusions:

    • Free muscle transplantation is a technically viable option for restoring finger flexion in the forearm.
    • Successful outcomes depend on meticulous surgical technique, particularly nerve repair and muscle tension.
    • The procedure can provide significant functional recovery, including range of motion, though grip strength may be limited.