Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.
  Table of Contents / Chapter 18:
Vascularized Muscle Transplantation and Gracilis Muscle Transplantation
  E. Finally, particular mention should be made of acute wounds fitting any of the above criteria. Early microvascular muscle transplantation in these situations may decrease morbidity, acute hospitalization and rehabilitation time, and delays before secondary reconstructive procedures.

2. Functional muscle restoration of paralyzed or inanimate parts:

A. Restoration of the long-finger flexors as a result of post-traumatic or postischemic insults (Volkmann's contracture). The gracilis muscle has been used in these patients. Wrist, ankle, knee, and elbow extension and flexion may also be restored with such dynamic transplants.

B. Reanimation of the paralyzed face. The serratus anterior muscle shows great promise in these patients. It is reinnervated through a previously placed cross-facial nerve graft, which parasitizes motor axons from the contralateral normal facial nerve.

C. Functional restoration of the intrinsic muscles of the thumb opposition along with vascularized cover and first web-space widening. The serratus anterior muscle is ideal for this application.


  1. Tamai, S., Kamatsu, S., Sakamoto, H., et al.: Free muscle transplants in dogs, with microsurgical neurovascular anastomoses. Plast. Reconstr. Surg. 46:219, 1970.

2. Maxwell, G., Manson, P., and Hoopes, J.: Experience with thirteen latissimus dorsi myocutaneous free flaps. Plast. Reconstr. Surg. 64:1, 1979.

3. Godina, M.: Preferential use of end-to-side arterial anastomoses in free flap transfers. Plast. Reconstr. Surg. 64:673, 1979.

4. Serafin, D., Sabatier, R., Morris, R., and Georgiade, N.: Reconstruction of the lower extremity with vascularized composite tissue: Improved tissue survival and specific indications. Plast. Reconstr. Surg. 66:230, 1980.

5. Get, R.: Muscle transposition for treatment and prevention of chronic post-traumatic osteomyelitis of the tibia. J. Bone Joint Surg. 59A:784, 1977.

6. Mathes, S., Alpert, B.S., and Chang, N.: Use of the muscle flap in chronic osteomyelitis: Experimental and clinical correlation. Plast. Reconstr. Surg. 69:815, 1982.

7. May, J., Lukash, F., and Gallico, G.: Latissimus dorsi free muscle flap in lower extremity reconstruction. Plast. Reconstr. Surg. 68:603, 1981.

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