TRANSPLANTATION OF THE GRACILIS MUSCLE TO RESTORE HAND FUNCTION

Free muscle transplantation with motor innervation offers the posibili ty to add contractile elements to upper extremities with extensive los s of musculature due to direct trauma or untreated compartment syndrom e (Volkmann's contracture). The functional cross section area and the mean resting fiber length determine the maximum power and the contract ing amplitude of the donor muscle. Although considerably weaker than t he finger flexors to be replaced, the gracilis muscle was the preferre d donor muscle because of its neurovascular pedicle and the minimal do nor site morbidity. In a series of 15 gracilis transplantations, all 1 3 muscles that survived regained function. Finger motion was dependent on the preoperative condition of tendons and joints. Even after compl ete loss of the flexor and extensor compartment a useful upper extremi ty could be restored, which was preferable to the only alternative - a mputation.