Free autogenous muscle transplantation in children. Long-term results.

For more than 15 years we have been using free muscle transplantation in the treatment of anal incontinence in children. This method implies transposition of a striated muscle, usually the palmaris longus, two weeks after denervation, to the perirectal area as a U-sling around the rectum corresponding to the location of the so-called puborectalis muscle. We have now evaluated the long-term results in all 26 children operated on by this method. Before the operation all children were totally incontinent after a primary repair. At follow-up after an average of 11 years and 4 months, 60% of the cases were regarded as good, 16% as fair, 8% as improved and 16% as failures. In our opinion, free muscle transplantation offers a good chance of achieving acceptable continence in a majority of incontinent children.