Double gracilis transfer

Unlock Your Hip Flexors

Unlock Your Hip Flexors

Get Instant Access

Doi et al [17,21,23,55] have described a method to provide shoulder stability and function combined with active elbow flexion and extension, hand sensibility, and rudimentary hand grasp and release function in patients with four or five root avulsions. The double free-muscle transfer takes advantage of the length of the gracilis muscle and proximal location of its neurovascular pedicle to promote rapid reinnervation of the muscle while allowing for distal joint function. A direct neu-rotization of the spinal accessory nerve to a gracilis muscle fixed to the clavicle can produce elbow flexion and finger or wrist extension (Fig. 2), whereas the second transfer, secured to the second rib and neurotized to intercostal motor nerves, creates finger flexion (Fig. 3). The creative use of additional intercostal nerves for triceps function and sensory neurotization of the hand allows

Fig. 1. The gracilis functioning free-muscle transfer for restoration of elbow flexion. The gracilis is fixed to the clavicle proximally and distally to the biceps tendon. Motor innervation is provided either by the spinal accessory or the third and fourth intercostal motor nerves. Vascular connections are made with the thor-acoacromial trunk vessels. (Courtesy of Mayo Foundation and Research, Rochester, MN; with permission.)

Fig. 1. The gracilis functioning free-muscle transfer for restoration of elbow flexion. The gracilis is fixed to the clavicle proximally and distally to the biceps tendon. Motor innervation is provided either by the spinal accessory or the third and fourth intercostal motor nerves. Vascular connections are made with the thor-acoacromial trunk vessels. (Courtesy of Mayo Foundation and Research, Rochester, MN; with permission.)

independent elbow flexion/extension and hand grasp/release if all components of the procedure are successful (Fig. 4).

Was this article helpful?

0 0
31 Days To Bigger Arms

31 Days To Bigger Arms

You can have significantly bigger arms in only 31 days. How much bigger? That depends on a lot of factors. You werent able to select your parents so youre stuck with your genetic potential to build muscles. You may have a good potential or you may be like may of the rest of us who have averages Potential. Download this great free ebook and start learns how to build your muscles up.

Get My Free Ebook


Post a comment