Krimmer H, Hahn P, Lanz U
Clinic for Hand Surgery Rhönklinikum, Germany.
Clin Orthop Relat Res. 1995 May(314):13-8.
Free muscle transplantation with motor innervation is the only way to add contractile elements to upper extremities with extensive loss of musculature due to direct trauma or untreated compartment syndrome (Volkmann's contracture). The functional cross-sectional area and the mean resting fiber length determine the maximum power and the contracting amplitude of the donor muscle, respectively. Although considerably weaker than the finger flexors to be replaced, the gracilis muscle was the preferred donor muscle because of the consistent anatomy of its neurovascular pedicle and the minimal donor site morbidity. In a series of 15 gracilis transplantations, all 13 muscles that survived regained function. Finger motion was dependent on the preoperative condition of tendons and joints. Even after complete loss of the flexor and extensor compartment after direct trauma or infection, a useful upper extremity could be restored, which was preferable to the only alternative--amputation.
带运动神经支配的游离肌肉移植是为因直接创伤或未治疗的骨筋膜室综合征（Volkmann挛缩）导致广泛肌肉组织缺失的上肢增加收缩元件的唯一方法。功能横截面积和平均静息纤维长度分别决定了供体肌肉的最大功率和收缩幅度。尽管比要替代的手指屈肌弱得多，但股薄肌因其神经血管蒂解剖结构一致且供区并发症最少，成为首选的供体肌肉。在一系列15例股薄肌移植手术中，存活的13块肌肉均恢复了功能。手指运动取决于术前肌腱和关节的状况。即使在直接创伤或感染后屈肌和伸肌间隔完全丧失后，仍可恢复有用的上肢功能，这比唯一的替代方案——截肢要好。
