Gracilis muscle anatomy as related to function of a free functioning muscle transplant

Abstract The purpose of this study was to establish the potential of the gracilis muscle to provide separate but controlled movement (e.g., independent finger flexion) when used as a free muscle transfer. The intramuscular neurovascular anatomy was studied in cadavers and in vitro. Through injection, dissection, and stimulation studies, it has been established that the distal gracilis can be separated longitudinally into at least two viable parts with independent neural control. This potential has been realized in ten clinical cases in which some separation of thumb and finger function has been achieved.