Free functional rectus femoris muscle transfer for restoration of extension of the foot after lower leg compartment syndrome

Abstract

In severely injured lower extremities with loss of the anterior compartment, the free functional rectus femoris musculocutaneous flap was used to restore extension of the foot and in soft-tissue reconstruction. From June 2000-July 2002, 3 patients were treated with this technique. Mean follow-up of the 3 patients was 27 months. Electromyography and the Stanmore system (recording pain, need for orthosis, ability to wear normal shoes, activity level, muscle power, active extension of the foot, and foot posture) were used to assess results of functional rectus femoris transfer. One patient had an excellent result, one patient had a good result, and one patient had a poor result, as assessed by the Stanmore system. Free functional rectus femoris transfer can obtain excellent results in treating foot-drop and soft-tissue defects due to lower leg compartment syndrome and loss of all muscles of the anterior compartment. (c)

Chimeric Functional Latissimus Flap Transfer to Restore Ankle Dorsiflexion following a Traumatic Defect of the Lower Leg: A Case Report

“…These include a reliable and predictable subscapular system facilitating the ability to harvest composite tissue, the ability to cover large wounds with relatively thin tissue, the ability to avoid inducing a new morbidity in the lower extremity, and the latissimus can supply a large skin paddle with sufficient size for large defects as opposed to the gracilis (smaller skin paddle) and the rectus femoris (insufficient length). 5 Additionally, functional success is variable with rectus femoris and gracilis flaps, 5,6 and in the setting of a lower extremity one should take great pause prior to inducing another lower extremity defect.…”

“…3 Although this may prove to be a difficult task, encouraging results are seen with functional muscle transfer. [4][5][6][7] Recently, the chimeric flap has gained popularity in its unique ability to restore composite defects of the lower extremity while maintaining economic tissue use and low donor-site morbidity. We present a case of a large composite defect of the anterior leg successfully repaired with a free chimeric functional latissimus dorsi flap resulting in functional dorsiflexion that has not previously been reported.…”

Free functional gracilis muscle transfer for reconstruction of massive ectopic calcification following a lower extremity fracture: a case report and overview of the literature

“…Successful functional recovery of active dorsiXexion of the foot and toe was achieved with this method. Even though other muscle or tendon transfers like the tibialis posterior tendon transposition over the tibialis anterior can result in functional improvement, but they cannot cover the exposed bone resulting from removed anterior muscular compartment [16,17].…”

“…Reinnervated free muscle transfer has proven to be invaluable in numerous reconstructive procedures e.g. soft-tissue tumor, brachial plexus and Volkmann's contracture [17][18][19][20][21][22]. Several muscles potentially meet the criteria for free functional muscle transfer.…”

DNA degradation in nuclei of muscle cells followed by ischemic injury in a rabbit amputation model

“…Revascularization of ischemic muscle is very common in reconstructive surgery in many different circumstances, including replantation, revascularization after trauma, thrombectomies, aortic reconstruction, treatment of compartment syndromes, and microsurgical transfer of muscle for function reconstructions. [1][2][3][4][5][6][7][8][9] In addition to the mechanism of ischemia, ischemia time is believed to be one of the major factors influencing survival and functional results. 1 When revascularization is attempted after a long ischemia time, irreversible degeneration of tissue cells may cause muscle necrosis and failure of salvage and functional reconstruction.…”