Application of free gracilis transplantation in reconstruction of traumatic limb / 中华创伤骨科杂志

ABSTRACT

Functional reconstruction of a major injured nerve or muscle group in a destructive limb caused by high energy has always been a big problem for trauma orthopedists.When no local tendon,muscle or nerve is available for transference,functional free muscle transplantation (FFMT) is an ideal functional reconstruction method for severe limb injury characterized by definite curative effect and quick recovery.Gracilis is considered to be an ideal donor site for FFMT because of its anatomic features of long tendon,good excursion,stable blood supply,long neurovascular pedicle,shaded donor site,little donor site loss and sufficient nourishment of the whole musculocutaneous flap by anastomosis of one single major pedicle.It has been widely applied in clinics.Transplantation of single free gracilis flap,double free gracilis flaps,and adductor longus-gracilis flap with single pedicle anastomosis can meet different clinical applications.The best donor motor nerve,which is critical to functional restoration of the affected limb using FFMT,is always a major concern to many scholars.This paper focuses on the advances in functioning free gracilis transplantation in reconstruction of limb motor function,applied anatomy of the gracilis and application of functional reconstruction for major nerve injury and major muscle group defects in a destructive limb,hoping to provide useful information for wider clinical application of FFMT.