Wade Sean M, Nesti Leon J, Wind Gary G, Howard Robert T, Souza Jason M
Department of Orthopaedics.
Department of Surgery, Uniformed Services University-Walter Reed National Military Medical Center Surgery, Bethesda, MD.
Tech Hand Up Extrem Surg. 2020 Mar;24(1):26-31. doi: 10.1097/BTH.0000000000000258.
Free functional gracilis transfer is a well-established technique for restoring active elbow flexion in brachial plexus injuries following delayed presentation or failed nerve reconstruction procedures. In cases of delayed presentation or failed nerve reconstruction following upper trunk injuries, the lower trunk intraplexal median and ulnar nerves are spared, thereby making them available to reinnervate the transferred gracilis. Therefore, we have inverted the conventional free functional gracilis orientation so as to orient the flap's recipient nerve in closer proximity to donor median or ulnar nerve fascicles to enable a short, tension-free coaptation in the middle to distal arm. Herein is our descriptive surgical technique for performing an inverted free functional gracilis muscle transfer in order to restore elbow flexion in the setting of an upper trunk injury.
游离功能性股薄肌转移术是一种成熟的技术，用于在出现延迟或神经重建手术失败后的臂丛神经损伤中恢复主动屈肘功能。在上干损伤后出现延迟或神经重建失败的情况下，下干内丛正中神经和尺神经得以保留，从而可用于重新支配转移的股薄肌。因此，我们颠倒了传统游离功能性股薄肌的方向，以使皮瓣的受区神经更靠近供体正中神经或尺神经束，从而在手臂中、远端实现短距离、无张力的吻合。本文介绍了我们进行倒置游离功能性股薄肌转移术以在上干损伤情况下恢复屈肘功能的描述性手术技术。
