The Serratus Anterior Free-Muscle Transplant for Reconstruction of the Injured Hand

摘要

The present study evaluated donor-site function in eight patients for whom serratus anterior free-muscle transplantation was performed to treat a traumatic defect of the palm. The lowest two or three slips of the muscle were transferred from the uninjured side and covered with split-thickness skin grafts. After an average follow-up period of 50 months (range 13 to 84 months), function and appearance of the flaps were assessed, and shoulder strength on the donor side was objectively tested in six patients by using an isokinetic computerized robotic dynamometer. No patient noticed any change in upper extremity function following the procedure. Each of the three patients in whom three slips had been taken displayed mild scapular winging, but none complained of any related symptoms. Neither push strength nor abduction strength on the donor side was significantly different compared with that on the recipient side. The transplanted muscle provided excellent contour and durable cover in all eight hands with limited donor-site morbidity. For this reason, the serratus anterior transplant is our flap of choice for the treatment of large palmar defects.