Addosooki Ahmad I, Doi Kazuteru, Hattori Yasunori
Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Ogori-Yamaguchi, Yamaguchi, Japan.
Tech Hand Up Extrem Surg. 2006 Dec;10(4):245-51. doi: 10.1097/01.bth.0000236986.43170.66.
In this article, we describe our technique and experience in harvesting the gracilis muscle for free functioning muscle transplantation (FFMT). The gracilis is the most commonly used muscle for FFMT. The main indication for gracilis FFMT is traumatic brachial plexus injury. Gracilis muscle has a class 2 vascular pedicle, with a dominant vascular pedicle originating from the profunda femoris vessels and a single motor nerve originating from the obturator nerve. During gracilis harvest, it is important to include the entire fascia around the muscle to ensure vascularity of the skin paddle and enhance muscle gliding in its new bed. Mobilization of the adductor longus allows tracing of the pedicle to its origin from the profunda femoris vessels, hence, achieving the maximum available length of the pedicle. Lengthening of gracilis tendon with a periosteal strip provides a free gracilis long enough to span the distance from the clavicle to the distal forearm. The main complications are related to the wound, and these include delayed healing, infection, and scar-related problems. The functional deficit after gracilis harvest is negligible.
在本文中，我们描述了我们在获取股薄肌用于游离功能性肌肉移植（FFMT）方面的技术和经验。股薄肌是FFMT最常用的肌肉。股薄肌FFMT的主要适应证是创伤性臂丛神经损伤。股薄肌有一个2级血管蒂，主要血管蒂起源于股深血管，单一运动神经起源于闭孔神经。在获取股薄肌时，重要的是要包括肌肉周围的整个筋膜，以确保皮瓣的血供并增强肌肉在新床中的滑动。内收长肌的游离可追踪血管蒂至其从股深血管的起源处，从而获得血管蒂的最大可用长度。用骨膜条延长股薄肌腱可提供一条足够长的游离股薄肌，以跨越从锁骨到前臂远端的距离。主要并发症与伤口有关，包括愈合延迟、感染和瘢痕相关问题。获取股薄肌后的功能缺陷可忽略不计。
