The use of the free functioning, innervated gracilis muscle has evolved to become
an invaluable tool in the restoration of elbow flexion and prehension in patients
undergoing reconstruction following brachial plexus injuries. Although there are many
different methods of the gracilis muscle harvest, most if not all harvest methods
begin proximally. The purpose of this article is to describe a novel distal harvest
technique of the gracilis myocutaneous flap for brachial plexus patients requiring
restoration of elbow or finger flexion. A harvest method commencing with a distal
dissection either at the distal insertion of the gracilis at the pes anserine or at
the distal medial thigh at the myotendinous junction will be described. The advantage
of this novel method is to ensure that the entire gracilis muscle and its tendon are
harvested to maximize the length of tendon that can be secured by a Pulvertaft weave
into the biceps tendon or the finger flexors for elbow flexion and finger flexion
respectively.
Keywords
harvest - gracilis muscle - tendon - muscle transfer - flap
