FREE GRACILIS MUSCLE TRANSPLANTATION FOR HAND RECONSTRUCTION

Free muscle transplantation with motor innervation is the only way to add contractile elements to upper extremities with extensive loss of m usculature due to direct trauma or untreated compartment syndrome (Vol kmann's contracture). The functional cross-sectional area and the mean resting fiber length determine the maximum power and the contracting amplitude of the donor muscle, respectively, Although considerably wea ker than the finger flexors to be replaced, the gracilis muscle was th e preferred donor muscle because of the consistent anatomy of its neur ovascular pedicle and the minimal donor site morbidity, In a series of 15 gracilis transplantations, all 13 muscles that survived regained f unction, Finger motion was dependent on the preoperative condition of tendons and joints. Even after complete loss of the flexor and extenso r compartment after direct trauma or infection, a useful upper extremi ty could be restored, which was preferable to the only alternative-amp utation.