Gordon L, Levinsohn D G, Finkemeier C, Angeles A, Deutch H
California Pacific Medical Center, School of Medicine, University of California, San Francisco.
Plast Reconstr Surg. 1993 Jul;92(1):97-101. doi: 10.1097/00006534-199307000-00014.
The present study evaluated donor-site function in eight patients for whom serratus anterior free-muscle transplantation was performed to treat a traumatic defect of the palm. The lowest two or three slips of the muscle were transferred from the uninjured side and covered with split-thickness skin grafts. After an average follow-up period of 50 months (range 13 to 84 months), function and appearance of the flaps were assessed, and shoulder strength on the donor side was objectively tested in six patients by using an isokinetic computerized robotic dynamometer. No patient noticed any change in upper extremity function following the procedure. Each of the three patients in whom three slips had been taken displayed mild scapular winging, but none complained of any related symptoms. Neither push strength nor abduction strength on the donor side was significantly different compared with that on the recipient side. The transplanted muscle provided excellent contour and durable cover in all eight hands with limited donor-site morbidity. For this reason, the serratus anterior transplant is our flap of choice for the treatment of large palmar defects.
本研究评估了8例行前锯肌游离肌肉移植治疗手掌创伤性缺损患者的供区功能。将肌肉最低的两到三条肌束从未受伤侧转移，并覆盖中厚皮片。平均随访50个月（范围13至84个月）后，评估皮瓣的功能和外观，并使用等速计算机化机器人测力计对6例患者供侧的肩部力量进行客观测试。术后无患者注意到上肢功能有任何变化。在取了三条肌束的3例患者中，均表现出轻度的肩胛翼状肩胛，但均无相关症状主诉。供侧的推拉力和外展力与受侧相比均无显著差异。移植的肌肉在所有8只手中均提供了良好的外形和持久的覆盖，且供区并发症有限。因此，前锯肌移植是我们治疗大面积手掌缺损的首选皮瓣。
