SEARCH · PubMed Health

Results for “MUSCLE TRANSPLANTATION”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMed1984

Urinary incontinence in children: treatment with free autogenous muscle transplantation.

Free autogenous muscle transplantation has now been carried out in 13 patients with anal incontinence and 16 patients with urinary incontinence. In anal incontinence the results have been excellent; all patients were improved and 12 out of 13 reached an acceptable level of continence. In 10 patients with urinary incontinence the results were good, with increase of functional bladder capacity and abandonment of nappies during the day. Two patients were improved and 4 were failures. Cinematographic studies in both anal and urinary incontinence clearly demonstrated the muscular activity of the transplants and confirmed the existence of a reinnervation process. The longest postoperative observation time is now 7-years in the anal patients and 6 years in the urinary patients.

Adolescent↗

PubMed2002

Basic science behind functioning free muscle transplantation.

Free muscle transfer is now a feasible procedure in several fields of reconstructive surgery. In this article, basic science behind clinical free muscle transfer, including essential aspects like donor muscle selection (type of blood supply, architecture of fibers, fiber length, and muscle volume), donor nerve selection, placement and routing of muscle, tension of muscle at suturing, postoperative monitoring of muscle circulation, postoperative reinnervation, and rehabilitation are discussed in detail.

Facial Paralysis↗

PubMed1998

Immunohistochemical analysis of clinically transplanted muscles.

BACKGROUND: Although a number of studies have examined the morphology and function of experimentally transplanted muscles, immunohistochemical evaluation of clinically transplanted muscles has not been reported. The purpose of this study was to examine clinically transplanted muscles at long periods after transplantation with biochemical markers specific for satellite cell activation and muscle regeneration. MATERIALS AND METHODS: Nine biopsies of muscles transplanted to the paralyzed face were examined. In five cases, the gracilis muscles were transplanted about 1 year after cross face nerve grafting. The other four cases underwent one-stage latissimus dorsi (LD) muscle transplantation. Twelve to 162 months after transplantation, muscle biopsies were harvested in nine cases. In eight cases, secondary corrections of facial expression including debulking of the grafted muscle were required, while another muscle was transplanted in one case because of the failed first operation. As control, six specimens of normal LDs were examined as well. Monoclonal antibodies were employed to visualize myosin heavy chain (MHC) isoforms (slow, fast, and embryonic) and MyoD protein. RESULTS: Although one specimen exhibited only small, atrophic fibers indicating failed reinnervation, the remaining eight specimens showed regularly distributed fibers and type grouping indicating successful reinnervation. There was no statistically significant difference in fiber area and lesser diameter between normal LDs and transplanted LDs. However, even in these successfully reinnervated muscles, intermediate and small fibers expressing embryonic MHC and small cells expressing MyoD were observed, suggesting that satellite cells were activated for repair of the adjacent fibers. CONCLUSIONS: Muscle adaptation (presumably to denervation), which is a regenerative change accompanied by activation of satellite cells, was still seen even long periods after transplantation. It is concluded that, in microneurovascular human skeletal muscle transfers, there is a wide variation in the time required for reinnervation of individual muscle fibers, and it may be that human muscle fibers cannot be properly reinnervated after denervation has continued for a certain period such as 12 months.

Adult↗

PubMed1992

Parallel-fibered muscles transplanted with neurovascular repair into bipennate muscle sites in rabbits.

Experiments were performed on 20 New Zealand White male rabbits. Our hypotheses were that (1) latissimus dorsi (LTD) muscles transplanted into the site of a bipennate rectus femoris (RFM) muscle with neurovascular repair would retain their parallel-fibered structure and (2) the parallel-fibered structure of latissimus dorsi grafts would reduce their total fiber cross-sectional area and adversely affect force development relative to that of bipennate rectus femoris grafts and muscles. Compared with their respective donor muscles, 120 to 150 days after grafting, latissimus dorsi and rectus femoris grafts showed no change in the number of fibers and a decrease in the mean single-fiber cross-sectional area to approximately 70 percent. The latissimus dorsi grafts, which remained parallel-fibered, developed maximum forces 34 and 23 percent of the values for fully activated rectus femoris grafts and muscles, respectively. The deficit in the maximum force of the latissimus dorsi grafts resulted primarily from the smaller total-fiber cross-sectional area as a result of the parallel-fibered structure.

Anastomosis, Surgical↗

PubMedDate not supplied

New muscle transplant method produces normal twitch tension in dystrophic muscle.

Grafting newborn muscle is an innovative method of muscle transplant. This method overcomes hypoxia in the deeper fibers and facilitates reinnervation and revascularization of the grafted muscle fibers, thus promoting the survival and development of the characteristics of the donor muscle. The result achieved is superior to that obtained from mature muscle grafts or from minced muscle transplants. When an intact soleus from a 1-day-old normal mouse was grafted into a recipient soleus of a 20-day-old dystrophic C57BL/6J-dy2J mouse, the actively developing normal graft helped to improve the structure and function of the dystrophic muscle. When compared to the intact dystrophic solei, the test dystrophic muscles five to six months after operation showed increases in cross-sectional area, in wet weight, in twitch and tetanic tension, and in the number of muscle fibers with high resting membrane potentials. This is the first procedure to have raised the muscle twitch tension in an adult dystrophic mouse to the normal level.

Action Potentials↗

PubMed2003

Transfer of one fascicle of ulnar nerve to functioning free gracilis muscle transplantation for elbow flexion.

BACKGROUND: In brachial plexus injury, elbow flexion is the first priority in reconstruction. Neglected cases need functioning free muscle transplantation that requires the donor nerve to supply the transplanted muscle. The purpose of this study was to investigate the effects and results of transferring one fascicle of the ulnar nerve to the transplanted gracilis muscle. METHODS: One woman and two men with neglected avulsions of the C5,C6 roots of the brachial plexus underwent free gracilis muscle transfer for elbow flexion. One fascicle of the ulnar nerve was used as the donor nerve. RESULTS: The mean period of follow-up was 33.3 months. The average reinnervation time of gracilis muscle was 3.7 months. At the final examination, the mean strength of elbow flexion was 4.3 kgf. The grip strength, moving two-point discrimination and the strength of the wrist volar flexion on the affected side was not worse than before surgery in any patient at the last follow-up examination. CONCLUSIONS: A fascicle of the ulnar nerve can be one of the most effective options for functioning free muscle transplantation for elbow flexion.

Adult↗

PubMed1980

An anatomical study of the pectoralis major muscle as related to functioning free muscle transplantation.

The prerequisites for a functioning free muscle transplant are reviewed. A method for studying the anatomy of the pectoralis major muscle is presented, giving special attention to the detail of the neurovascular structures. Fifteen meticulous dissections, documented by sketches and photographs, provide the data base. This work is summarized in Table I and Figure 3. The variability is stressed in Table II. None of the variations observed preclude the use of the inferior four-fifths of the sternocostal muscle as a functioning free muscle transplant. The length and bulk of this muscle are advantages for its use in replacing forearm flexors. The multiple innervations may be an advantage or disadvantage, depending on the availability of the motor nerves in the recipient site. The time-consuming dissection is a disadvantage. With this knowledge, the reconstructive surgeon can assess the advisability of using the pectoralis major muscle as a functioning free muscle transplant.

Female↗

PubMed1991

Histomorphometric studies in patients with facial palsy treated by functional muscle transplantation: new aspects for the surgical concept.

Whenever it was possible, muscle and nerve biopsies were performed in patients with irreversible, unilateral facial palsy treated by cross-face nerve grafting and free gracilis muscle transplantation with microneurovascular anastomoses. Planimetric analyses of cross-sections showed the following, to some extent, surprising, results: (1) Independent of the final functional result, approximately the same number of regenerated, thin nerve fibers (100-200) were found in the distal end of the cross-face nerve graft at the time of muscle transplantation. These are approximately 20% of the nerve fibers counted in the branches of the facial nerve at the healthy side used for reinnervation. (2) There is no correlation between the number or diameter of the nerve fibers in the distal end of the cross-face nerve graft and the functional recovery of the transplanted muscle, but there is good correlation between the morphology of the fibers of the muscle graft and the functional result. (3) Different portions of slow-contracting and fast-contracting muscle fibers in the reinnervated muscle grafts showed the strong influence of the quality of the nerve used for the crossover innervation. If a facial nerve branch innervating the slow buccinator muscle was used, the originally fast gracilis muscle was transformed to a slow muscle by this kind of reinnervation. These important findings are the basis of a new view of surgery in the treatment of irreversible facial palsy by functional free-muscle transplantation.

Biopsy↗

PubMed1995

Functioning free muscle transplantation for brachial plexus injury.

Sixty-four cases of functioning free muscle transplantation to reconstruct brachial plexus injuries were reviewed for the years 1986 to 1991. Results were assessed using the Medical Research Council grading system, and success was defined as a muscle strength rating of 4 (ability to lift at least 1 kg). Functioning free muscle transplantation for shoulder abduction was ineffective because of its complex requirements. Functioning free muscle transplantation for biceps replacement using 2 or 3 intercostal nerves for innervation is a recommended procedure (success rate, to 80%). For function below the elbow, an intercostal nerve or spinal accessory (XI) nerve to innervate the functioning free muscle transplantation in flexor digitorum profundus replacement was inadequate. A new strategy for functions below the elbow was developed as a staged operation. The first operative stage involved either transfer of the ipsilateral upper trunk (in cases with lower plexus avulsion injury associated with upper trunk rupture) or contralateral C7 spinal nerve (in cases with total root avulsion injury) to the selected paralytic nerve. The second stage involved functioning free muscle transplantation, such as biceps or flexor digitorum profundus replacement for special function. No functioning free muscle transplantation for triceps or intrinsic hand function was tried.

Accessory Nerve↗

PubMed1976

[Experimental investigations of muscle transplants in correction of congenital diaphragmatic defects (author's transl)].

Rives muscle plasty using a pediculate flap of the latissimus dorsi muscle is an approved method for correction of large congenital diaphragmatic defects. To study morphology and function of the transplanted muscle flap 10 beagle dogs were operated upon bilaterally in two stages. Thus a total of 20 muscle transplants was evaluated. A standard Rives plasty was performed, emg electrodes were inserted into the diaphragm as well as into the muscle transplant. The surgical procedure was tolerated very well, there was no operative mortality. The period of observation varied between 18 and 48 weeks, the average being 30 weeks. Postoperatively there was no electric activity found in the muscle transplants, whereas the diaphragm showed its characteristic interference pattern during inspiration. In 5 cases, however, action potentials appeared in the muscle flap after 12 to 16 weeks. They had the semblance of fibrillation potentials and short sharp waves and were considered to be preceding reinnervation potentials, which occured 24 to 32 weeks postoperatively in these cases. In 2 cases the emg findings were inconstant, in the residual 13 cases there was no electrical activity in the muscle transplant during all the observation time. The emg findings corresponded to the histological postmortem findings. These showed in altogether 6 cases numerous intact muscle fibres as well as nerve trunks with neurites, especially in the neighbourhood of the diaphragm. In the middle of the flap and even more near the thoracic wall the number of intact muscle fibres decreased. Thus a partial reinnervation due to muscular neurotization starting from the diaphragmatic margin was assumed in these cases. In the rest of the flaps the muscles were largely atrophic and showed considerable lipomatosis, only minor fibrosis and never a distinct scar formation. Therefore, the flaps represented living tissue with intact vascularization and functionally good adaptability. Reinnervation, observed in some cases, is not the main factor for the good clinical results obtained with Rives muscle plasty, but can improve adaptability and elasticity of the transplant considerably. According to the lack of scar formation and the preponderance of fatty tissue an increase of the transplant considerably. According to the lack of scar formation and the preponderance of fatty tissue an increase of the transplants size during growth seems possible. Thus Rives muscle plasty using a flap of the latissimus dorsi muscle to cover large congenital diaphragmatic defects seems morphologically as well as functionally superior to other procedures especially those using plastic material.

Animals↗

PubMed1978

Free muscle transplantation to provide active finger flexion.

Free muscle transplatation is a procedure which involves the transfer of a skeletal muscle from one location in the body to another. Viability is maintained by microvascular anastomoses of the muscle's artery and vein to a suitable artery and vein in the recipient site. Voluntary muscle contraction is obtained by suturing of the muscle's motor nerve to an appropriate motor nerve in the recipient site. Two cases are presented; one using the gracilis and the other using the pectoralis major muscle. The indication for each transplantation was the traumatic loss of long flexor musculature to the digits. In both cases transplanted muscles survived and are functioning well. Excellent grip strength and nearly a full range of finger movement were provided by the transplanted muscle.

Adolescent↗

PubMed1984

Muscle transplantation by fascicular territory.

In some muscles, distinct and separate portions of the muscle are each under the control of a different fascicle of the motor nerve. Although there is some slight overlap in areas, this unit, a single fascicle muscle territory, is present in the gracilis muscle. Microneurovascular techniques have improved the reliability of muscle transplantation for the reconstruction of facial paralysis. The amount of movement obtained depends on many factors, including the amount of muscle transplanted and the adequacy of its reinnervation. The ability to transplant a small segment of a muscle based on the fascicular territory enables the surgeon to supply the amount of movement that each individual patient requires.

Adult↗

PubMed1985

[Free muscle transplantation].

To survey the current use of free muscle transplantation in the German speaking part of Europe, a questionnaire was sent to all Replantation Centres in 1982/1983. The answers revealed that micro-neurovascular muscle transplantation for functional use is still an uncommon procedure. Its use in facial palsy, in the sphincter region and in reconstructive procedures in extremities is emphasized and postoperative healing and functional improvement is shown in a diagram. The follow-up period is too short to discuss functional improvement in detail. Regarding our own cases, we are quite impressed by the result of free microneurovascular muscle transplantation in unilateral irreversible facial palsy patients, but are unable to prove the final result in extremities because of short observation time.

Adult↗

PubMed2006

Microneurovascular anatomy of the peroneus brevis muscle in the NZW-rabbit: a new model for free functional muscle transplantation.

This study introduces the peroneus brevis muscle of the NZW-rabbit as a new model for free functional muscle transplantation. The muscle originates from the lateral aspect of the knee joint and inserts on the 5th metatarsal with a circumscript tendon. It can be harvested with a 7 cm long motor nerve branch. In a series of 22 animals divided in two groups with a body weight of 3.19 +/- 0.30 kg and 4.81 +/- 0.38 kg respectively, vessel diameter of the supplying artery was found to be 0.3-0.35 mm in group one and 0.40-0.45 mm in group two, the two concomitant veins were 1.1-1.4 mm in diameter in the first group and 1.2-1.6 mm in the second group. Histomorphometric analysis stained with NADH showed 3.67 +/- 3.21% type I fibers, 25.41 +/- 7.87% type IIa fibers, and 70.93 +/- 9.12% type IIb/d fibers.

Animals↗

PubMed1981

[Flapped and free muscle transplantation in the treatment of anal incontinence (author's transl)].

49 patients with continence-improving operations were reviewed. 41 children underwent a gracilis-transplantation according to Pickrell, 6 patients a free muscle transplantation according to Hakelius/Grotte and 2 patients a smooth muscle graft according to Schmidt. The clinical and manometrical results were compared with data from the literature. Furthermore a new technique of smooth muscle transplantation in the young infant is described. During an abdomino-sacroperineal pull-through procedure a flapped smooth muscle transplantation is performed simultaneously. The circular and longitudinal muscle layer of the pulled-through colon will be turned back and is fixed on the serosa under light tension. Afterwards the whole muscle cuff is repulled into the puborectalis sling. Examinations of the anorectal pressure as well as X-ray investigations showed a good function of the newly-established internal anal sphincter equivalent.

Adolescent↗

PubMed1995

Free gracilis muscle transplantation for hand reconstruction.

Free muscle transplantation with motor innervation is the only way to add contractile elements to upper extremities with extensive loss of musculature due to direct trauma or untreated compartment syndrome (Volkmann's contracture). The functional cross-sectional area and the mean resting fiber length determine the maximum power and the contracting amplitude of the donor muscle, respectively. Although considerably weaker than the finger flexors to be replaced, the gracilis muscle was the preferred donor muscle because of the consistent anatomy of its neurovascular pedicle and the minimal donor site morbidity. In a series of 15 gracilis transplantations, all 13 muscles that survived regained function. Finger motion was dependent on the preoperative condition of tendons and joints. Even after complete loss of the flexor and extensor compartment after direct trauma or infection, a useful upper extremity could be restored, which was preferable to the only alternative--amputation.

Adolescent↗

PubMed1989

The principles of functioning muscle transplantation: applications to the upper arm.

Functioning muscle can be transferred from one location to another using microneurovascular anastomoses. Reinnervation and useful muscle contraction are produced by suturing an appropriate motor nerve in the recipient area to the motor nerve of the transplanted muscle. Clinical experience and experimental investigations have led to an understanding of some of the important principles in extremity muscle transplantation. Successful deltoid and biceps reconstruction are reported.

Adult↗

PubMed1995

Cerebral revascularization using gracilis muscle transplantation for childhood moyamoya disease.

BACKGROUND: Omental transplantation is effective in the management of ischemia in the territories of the anterior and posterior cerebral arteries in childhood moyamoya disease. We introduced a surgical revascularization using gracilis muscle transplantation to these territories. METHODS: Between January 1991 and May 1993, six children with moyamoya disease, between the age of 3 and 13 years, underwent gracilis muscle transplantation to the territory of either the anterior or the posterior cerebral artery. The mean period of follow-up after surgery was 15.2 months, with a range of 5 to 32 months. Three of the six patients had suffered from frequent transient visual disturbance and were treated with unilateral or bilateral gracilis muscle transplantation to the territory of the posterior cerebral artery. The other three patients had suffered from frequent transient paraparesis, mental retardation, and/or rectal and urinary incontinence, and were treated with gracilis muscle transplantation bilaterally to the territories of the anterior cerebral arteries. RESULTS: All three patients with gracilis muscle transplantation unilaterally or bilaterally to the occipital lobes manifested complete disappearance of their symptoms. Two of the three patients with gracilis muscle transplantation bilaterally to the frontal lobes also manifested complete disappearance of their symptoms. The remaining patient who underwent the transplantation bilaterally to the frontal lobes, continued to have episodes of transient paraparesis, postsurgically, but the frequency of symptoms was markedly decreased. CONCLUSIONS: Ischemia in the territories of the anterior and/or posterior cerebral arteries could be overcome with the use of gracilis muscle transplantation in childhood moyamoya disease.

Adolescent↗