Free functional muscle transfer for lower extremity reconstruction.

Free flap Free functional muscle transfer Functional reconstruction Lower extremity Microsurgery

Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
11 2023
Historique:
received: 20 03 2023
revised: 30 08 2023
accepted: 12 09 2023
medline: 6 11 2023
pubmed: 5 10 2023
entrez: 5 10 2023
Statut: ppublish

Résumé

Free functional muscle transfer is a reconstructive strategy for the reconstruction of lost muscle units in the lower extremity after oncologic resection, trauma, compartment syndrome, or severe nerve injuries. Under appropriate circumstances, free functional muscle transfer may be the only suitable reconstructive option. This article reviews the underlying principles of free functional muscle transfer, its application to lower extremity reconstruction, appropriate patient selection, and surgical techniques. The underlying principles of free functional muscle transfer, its application to lower extremity reconstruction, appropriate patient selection, and surgical techniques are presented. Commonly used donor muscles appropriate for each type of functional defect are discussed. A review of recent publications on free functional muscle transfer in the lower extremity was also performed. Good functional recovery with a Medical Research Council grade of up to 4/5 and full range of motion can be attained with free functional muscle transfer. Clinical outcomes and specific parameters for published case series in lower extremity free functional muscle transfer are presented and an illustrative case. Free functional muscle transfer is a suitable treatment for the appropriate patient to restore essential functions and potentially regain ambulation. However, additional published clinical outcomes are needed and represent a major area for further investigation.

Sections du résumé

BACKGROUND
Free functional muscle transfer is a reconstructive strategy for the reconstruction of lost muscle units in the lower extremity after oncologic resection, trauma, compartment syndrome, or severe nerve injuries. Under appropriate circumstances, free functional muscle transfer may be the only suitable reconstructive option. This article reviews the underlying principles of free functional muscle transfer, its application to lower extremity reconstruction, appropriate patient selection, and surgical techniques.
METHODS
The underlying principles of free functional muscle transfer, its application to lower extremity reconstruction, appropriate patient selection, and surgical techniques are presented. Commonly used donor muscles appropriate for each type of functional defect are discussed. A review of recent publications on free functional muscle transfer in the lower extremity was also performed.
RESULTS
Good functional recovery with a Medical Research Council grade of up to 4/5 and full range of motion can be attained with free functional muscle transfer. Clinical outcomes and specific parameters for published case series in lower extremity free functional muscle transfer are presented and an illustrative case.
CONCLUSION
Free functional muscle transfer is a suitable treatment for the appropriate patient to restore essential functions and potentially regain ambulation. However, additional published clinical outcomes are needed and represent a major area for further investigation.

Identifiants

pubmed: 37797377
pii: S1748-6815(23)00547-8
doi: 10.1016/j.bjps.2023.09.041
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

288-299

Informations de copyright

Copyright © 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest DC, SR, KT, WYZ, AMK, JGB, and RPP have no financial disclosures or any conflicts of interest to report. THT is a member of the Scientific Advisory Board of Neuraptive Therapeutics Inc.

Auteurs

David Chi (D)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA.

Shreya Raman (S)

Division of Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, VA, USA.

Kenan Tawaklna (K)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA.

William Y Zhu (WY)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA.

Alexandra M Keane (AM)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA.

Jordan G Bruce (JG)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA.

Rajiv Parikh (R)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA; Department of Plastic and Reconstructive Surgery, Medstar Georgetown, Washington, DC, USA.

Thomas H Tung (TH)

Division of Plastic and Reconstructive Surgery, Washington University Medical Center, Saint Louis, MO, USA. Electronic address: tungt@wustl.edu.

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Classifications MeSH