Closure of difficult vaginal fistulas using the gracilis muscle

A retrospective study of the surgical repair of 27 cases of acute gracilis muscle rupture ("dropped back muscle") in 23 racing greyhounds was conducted.All of the dogs suffered the injury while racing or training. Suture materials and surgical technique are described. The dogs ability to resume racing was assessed.

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Facial Reanimation of Patients With Neurofibromatosis Type 2

Operative Neurosurgery ◽

10.1227/neu.0b013e31823a819f ◽

2011 ◽

Vol 70 (suppl_2) ◽

pp. ons237-ons243 ◽

Cited By ~ 2

Author(s):

Kalpesh T. Vakharia ◽

Doug Henstrom ◽

Scott R. Plotkin ◽

Mack Cheney ◽

Tessa A. Hadlock

Keyword(s):

Facial Paralysis ◽

Neurofibromatosis Type ◽

Neurofibromatosis Type 2 ◽

Gracilis Muscle ◽

Single Stage ◽

Care Plan ◽

Muscle Transfer ◽

Facial Reanimation ◽

Oral Commissure

ABSTRACT BACKGROUND: Neurofibromatosis type 2 (NF2) is a tumor suppressor syndrome defined by bilateral vestibular schwannomas. Facial paralysis, from either tumor growth or surgical intervention, is a devastating complication of this disorder and can contribute to disfigurement and corneal keratopathy. Historically, physicians have not attempted to treat facial paralysis in these patients. OBJECTIVE: To review our clinical experience with free gracilis muscle transfer for the purpose of facial reanimation in patients with NF2. METHODS: Five patients with NF2 and complete unilateral facial paralysis were referred to the facial nerve center at our institution. Charts and operative reports were reviewed; treatment details and functional outcomes are reported. RESULTS: Patients were treated between 2006 and 2009. Three patients were men and 2 were women. The age of presentation of debilitating facial paralysis ranged from 12 to 50 years. All patients were treated with a single-stage free gracilis muscle transfer for smile reanimation. Each obturator nerve of the gracilis was coapted to the masseteric branch of the trigeminal nerve. Measurement of oral commissure excursions at rest and with smile preoperatively and postoperatively revealed an improved and nearly symmetric smile in all cases. CONCLUSION: Management of facial paralysis is oftentimes overlooked when defining a care plan for NF2 patients who typically have multiple brain and spine tumors. The paralyzed smile may be treated successfully with single-stage free gracilis muscle transfer in the motivated patient.

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Does technical components of microanastomoses influence the functional outcome of free gracilis muscle transfer for elbow flexion in traumatic brachial plexus injury?

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2021.102827 ◽

2021 ◽

pp. 102827

Author(s):

Francisco Vilmar Felix Martins-Filho ◽

Fernanda do Carmo Iwase ◽

Gustavo Bersani Silva ◽

Alvaro Baik Cho ◽

Teng Hsiang Wei ◽

...

Keyword(s):

Brachial Plexus ◽

Functional Outcome ◽

Brachial Plexus Injury ◽

Elbow Flexion ◽

Gracilis Muscle ◽

Muscle Transfer

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Ultrasonic evaluation of muscle functional recovery following free functioning gracilis transfer, a preliminary study

European Journal of Medical Research ◽

10.1186/s40001-020-00473-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Yi Hou ◽

Jiantao Yang ◽

Bengang Qin ◽

Liqiang Gu ◽

Jia Zheng

Keyword(s):

Muscle Strength ◽

Functional Recovery ◽

Linear Regression Analysis ◽

Gracilis Muscle ◽

Ultrasound Measurement ◽

Multivariate Linear Regression Analysis ◽

Joint Mobility ◽

Post Transplant ◽

Rest State ◽

Contraction Ratio

Abstract Background Ultrasonic measurement has not been utilized to assess the functional recovery of transplanted muscle. This study aimed to investigate the feasibility of using B-ultrasound measurement to assess muscle recovery following free functioning gracilis transfer. Methods From January 2009 to January 2014, 35 patients receiving free functioning gracilis transfer to treat total brachial plexus injury were enrolled. B-ultrasound was adopted to determine the cross-sectional area (CSA) of transplanted gracilis muscle at rest and contraction state. The ratio of pre- to post-transplant CSA value at rest state was defined as muscle bulk ratio (MBR). The ratio of CSA value at contraction state to rest state was defined as contraction ratio (CR). Results Patients with muscle strength M ≥ 4 had significantly higher CR1 (post-transplant), CR2 (pre-transplant), and range of motion (ROM, joint mobility) than those with muscle strength M < 4. The CR1 > CR2 group had significantly higher CR1, muscle strength, and ROM than the CR1 ≤ CR2 group. The MBR > 1 group had significantly higher muscle strength than the MBR ≤ 1 group. CR1 value was highly correlated with muscle strength and with ROM. CR2 value was moderately correlated with muscle strength and ROM. Multivariate linear regression analysis showed that a higher CR1/CR2 value was associated with a higher muscle strength and joint mobility. The CR1 > CR2 group had better muscle strength and ROM than the CR1 ≤ CR2 groups. Conclusion B-ultrasound measurement can quantitatively reflect muscle strength following gracilis transfer, and CR value could be a potential indicator for functional recovery of the transplanted gracilis muscle. Level of Evidence: Prognostic studies, Level II.

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