Recovery of function in free muscle transplants using microneurovascular anastomoses

Terzis, Julia K.; Sweet, Robert; Dykes, Robert W.; Williams, H. Bruce

doi:10.1016/s0363-5023(78)80116-6

Cited by 104 publications

(35 citation statements)

References 15 publications

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“…This suggests the importance of other factors which have a role in atrophy of muscle ~e l l s .~'~~~ As demonstrated by several studies on both free muscle grafts and free muscle transplants, muscle is very susceptible to ischaemia and denervation, as well as to lack of tension. 1*33, 34 In our study, both the blood supply and tension were disturbed during the prefabrication and transfer stages. Although none of the flaps suffered more than 90 minutes of warm ischaemia during transfer, optimal resting tension was never restored throughout the study owing to the fact that the main concern was given to the reinnervation and neovascularisation processes.…”

Section: Discussionmentioning

confidence: 66%

Reinnervation and neovascularisation in prefabricated free muscle flaps

et al. 1995

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In this study, immediate muscle reinnervation in flap prefabrication was investigated and compared with those flaps which were reinnervated after prefabrication. Using the flow-through wrap-around technique for neovascularisation, denervated external abdominal oblique random muscle flaps in Lewis rats were either immediately reinnervated by implantation of the epigastric nerve or reinnervated late after free transfer, following the prefabrication period of 15 days. Half of the flaps from each group were microsurgically transferred to isogeneic rats. Thirty days later, the flaps were harvested, and neovascularisation and reinnervation were studied with microangiography and immunohistochemistry using antibodies to protein gene peptide (PGP) 9.5, calcitonin gene-related peptide (CGRP), and von Willebrand factor (vWF). Microangiography and quantification of the vWF-stained vessels in the flaps confirmed increased neovascularisation over a longer time course. Reinnervation was found to have no influence over neovascularisation. Nerve sprouting was present 15 days after nerve implantation to the muscle and became widespread by 30 days. CGRP immunoreactivity, which is thought to have some role in trophic and regulatory processes, was observed only after 30 days of reinnervation. Regardless of the timing and extent of reinnervation, a considerable amount of muscle atrophy was observed in the flaps.

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Section: Discussionmentioning

confidence: 66%

Reinnervation and neovascularisation in prefabricated free muscle flaps

et al. 1995

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“…However energetically one tries to be scientific in compiling the results, it in the end depends on the degree of movement, symmetry, and response to emotion. Over complex measurements tend merely to confuse (figs [2][3][4] Electromyographic studies were carried out early on in the study but we were hoping to see a trend towards increase in speed of conduction across the nerve graft with the proceeding myelination and perhaps increased amplitude in the muscle relating to strength, but in fact these trends were not really forthcoming.…”

Section: Resultsmentioning

confidence: 99%

Treatment of infants with facial palsy.

Harrison¹

1994

Archives of Disease in Childhood

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“…However, the importance of restoring the original tension of the muscle transplant was clearly shown by Terzis [38] and Manktelow [29]. When the gracilis is transferred for elbow flexion and hand reanimation, the distance from the clavicle to the hand is much longer than the original length of the muscle in the thigh.…”

Section: One Muscle Transfer For Simultaneous Reconstruction Of Two Fmentioning

confidence: 99%

Free Muscle Transfer in Posttraumatic Plexopathies Part II: The Elbow

Terzis¹,

Kostopoulos

2009

Hand (New York, N,Y.)

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The indications for free muscle transfer in brachial plexopathies are prolonged denervation time or inadequate upper extremity function after primary nerve reconstruction. The purpose of this study is to analyze the outcomes of free muscle transfer for elbow flexion and extension in brachial plexopathies in relation to the different muscles used and the respective motor donors. Seventy-three muscles were transferred for elbow flexion and ten for elbow extension. Latissimus dorsi (LD) was used in 37 cases, gracilis in 28, rectus femoris (RF) in seven, and vastus lateralis in one. Five LD and five gracilis were transferred for elbow extension. Patients younger than 15 years yielded better results than older patients for elbow flexion. When LD was transferred, the mean muscle grading (MG) was 3.33±0.25 when the neurotization was from intercostals; these outcomes were statistically significant when compared with outcomes of free gracilis transfer (MG 2.25±0.6). There was also a statistically significant difference when free LD was neurotized with three intercostals as compared with two intercostals nerves. RF yielded also good results when neurotized from contralateral C7 (cC7; MG 3.67±0.6). For elbow extension, the better outcomes of LD were not statistically significant. Among all the free muscle transfers for upper extremity reconstruction, elbow reanimation yielded the most rewarding outcomes. The selection of powerful muscle units was more important than the effect of neurotization which was not as strong as it was in muscle transfers for facial or hand reanimation.

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Recovery of function in free muscle transplants using microneurovascular anastomoses

Cited by 104 publications

References 15 publications

Reinnervation and neovascularisation in prefabricated free muscle flaps

Reinnervation and neovascularisation in prefabricated free muscle flaps

Treatment of infants with facial palsy.

Free Muscle Transfer in Posttraumatic Plexopathies Part II: The Elbow

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