The versatility of the use of free-functioning gracilis muscle flap in the reconstruction of deficient motor unit

Abstract

Introduction Free gracilis muscle transfer can provide reliable reconstruction of cases of lost motor unit. The aim of this study was to describe the surgical techniques used for harvesting the gracilis muscle used for reconstruction of facial paralysis and brachial plexus palsy. Patients and methods Ten patients underwent free gracilis muscle transfer. Short gracilis muscle transfer was used for facial reanimation. Extended gracilis muscle transfers were used to reconstruct patients with brachial plexus palsy. Results All of the transferred muscles were survived completely except one. The overall success rate was 90%. The average time for the start of reinnervation was 3.74 months (range, from 3 to 5 months). Discussion We used free gracilis flap for reconstruction of delayed cases with deficient motor unit. Tamai was the first to describe free microvascular transfer in dogs. Harii was the first to describe free gracilis flap in humans. The gracilis muscle has a constant anatomy, long tendon, and good excursion with few donor site morbidities. Conclusion The gracilis muscle is recommended for use as a free-functioning muscle flap for reconstruction of delayed cases of motor paralysis as in cases of facial nerve injury and brachial plexus injury.