Free functional muscle transfer in treatment of upper and lower limb functional defects

A functioning free muscle transfer such as gracilis, rectus femoris, latissimus dorsi, tensor fascia lata or serratus anterior muscle can be used to bring a healthy muscle into the area where irreversible fibrofatty degeneration has been developed. The muscle is harvested along with its nerve which is sutured to a healthy intraplexal or extraplexal nerve.Functioning free muscle transfer is a viable reconstruction for restoration of upper-extremity function in the case of severe brachial plexus injury. It is possible to achieve good to excellent outcomes of muscle grades with simultaneous reconstruction of two functions by one FFMT, making restoration of basic hand function possible. More reliable results obtained when a single FFMT is performed for single function.Restoration of lost apposition in thenar soft tissue and muscle defects, can be achieved using a free functional muscle transfer. This procedure clinically gives excellent functional results and carried out as single stage reconstructive procedure.In Volkmann’s ischaemic contracture, there is loss of functioning muscle unit at both flexor and extensor side. FFMT is used to replace muscle deficit in forearm for finger flexion and finger extension.Functional reconstruction of Achilles tendon with large tissue defect can be achieved by using the FFMT as tensor fascia lata muscle to reconstruct the Achilles tendon and to cover skin defect.Free functional rectus femoris transfer can obtain excellent results in treating knee extension and soft tissue defect due to trauma and loss of quadriceps femoris muscles.Free functional muscle transfer in treatment of upper and lower limb functional defects where irreversible fibrofatty degeneration has been developed is a good option to solve this problem as long as there is a good preoperative, intra-operative meticulous techniques, postoperative follow up and good rehabilitation programs were applied.