title: Functional free muscle transfer for upper extremity reconstruction.
abstract: BACKGROUND
  Functional losses in the upper extremity that cannot be restored by nerve or tendon transfer present a treatment dilemma to the reconstructive surgeon. Common indications for functional free muscle transfer include late reconstruction of brachial plexus injuries, traumatic muscle loss, Volkmann ischemic contracture, loss resulting from oncologic resection, and congenital absence of motor function as seen in arthrogryposis.
  
  
  METHODS
  This article reviews the authors' experience in upper extremity reconstruction using functional free muscle transfer. The indications and technique for functional free muscle transfer in the upper extremity are reviewed. Surgical details for sites of reconstruction and the nuances of harvesting the main donor muscles are presented.
  
  
  RESULTS
  Specific cases and outcome reviews for several series of functional free muscle transfers are presented.
  
  
  CONCLUSIONS
  Functional free muscle transfer is the best and final option for restoring function in an otherwise nonreconstructible limb.
authors.affiliation: Los Angeles, Calif. From the Department of Orthopedics, University of Southern California Keck School of Medicine.
authors.forename: Milan
authors.initials: M
authors.lastname: Stevanovic
authors.forename: Frances
authors.initials: F
authors.lastname: Sharpe
mesh_terms: D000293:Adolescent; D002648:Child; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D018579:Patient Selection; D019990:Perioperative Care; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000534:rehabilitation; D020127:Recovery of Function; D034941:Upper Extremity / Q000293:injuries / Q000601:surgery*; D055815:Young Adult
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