Gracilis muscle transfer : dynamometric and clinical evaluation of donor-site defects

Gracilis muscle transfer is used for covering defects and restoring function. The aim of this study was to evaluate donor-site function including hip adductor muscle strength, upper leg circumference, hip and knee joint mobility, and subjective deficits after gracilis muscle transfer. 36 patients, aged 16 to 77 years, were examined after an average follow-up period of 5 years. Isometric muscle strength of hip adductor and knee extensor were objectively tested by computerized dynamometry, joint range-of-motion was measured goniometrically, upper leg circumference by tape measure, and muscle strength was additionally evaluated by hand. Furthermore, patients were asked if they suffered from impairments in everyday life and sports. The dynamometric results revealed significantly impaired strength parameters for hip adduction of the donor extremity compared to the other leg, whereas no side differences were found in knee extension. The upper leg circumference was reduced in the operated side. Hip and knee joint range-of-motion, as well as manual muscle strength testing did not show any relevant differences of the two sides. There was only 1 patient who noticed a subjective change in lower extremity function after having lost the gracilis muscle. The dynamometric findings of this trial, however, were sensitive enough to reveal a subclinical deficit, which might cause clinical impairment in the long run.