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Nguyen et al. Plast Aesthet Res 2019;6:31 Plastic and
DOI: 10.20517/2347-9264.2019.42 Aesthetic Research

Original Article Open Access

The technique of utilizing a single gracilis functional
muscle transfer to restore quadriceps function

following sarcoma surgery

Christopher M. Nguyen , Imran Ratanshi , Jennifer L. Giuffre , Edward W. Buchel , Thomas E. J.
2
1
1
1
Hayakawa 1
1 Section of Plastic Surgery, Department of Surgery, University of Manitoba, Winnipeg R3A 1R9, Canada.
2 The Plastic Surgery Group, Fraser Health Authority, Surrey, British Columbia V3V 1Z2, Canada.
Correspondence to: Dr. Thomas E. J. Hayakawa, FRCSC, Section of Plastic Surgery, Department of Surgery, University of
Manitoba, 820 Sherbrook St, Winnipeg, Canada. E-mail: thplastic@hotmail.com

How to cite this article: Nguyen CM, Ratanshi I, Giuffre JL, Buchel EW, Hayakawa TEJ. The technique of utilizing a single gracilis
functional muscle transfer to restore quadriceps function following sarcoma surgery. Plast Aesthet Res 2019;6:31.
http://dx.doi.org/10.20517/2347-9264.2019.42

Received: 24 Oct 2019 First Decision: 26 Nov 2019 Revised: 5 Dec 2019 Accepted: 12 Dec 2019 Published: 19 Dec 2019
Science Editor: Matthew L. Iorio Copy Editor: Jing-Wen Zhang Production Editor: Jing Yu

Abstract

Aim: Quadriceps strength and knee extension, the most important factors limiting the ability to rise from a chair,
are crucial for walking at an appropriate speed, ascending and descending stairs, and performing activities such as
running, dancing, and jumping. Resection of the anterior compartment of the thigh, including all four quadriceps
muscles, for the treatment of a sarcoma is uncommon; however, when necessary, it is very debilitating and adversely
affects a patient’s quality of life without functional reconstruction. Currently, there are a limited number of complex
and difficult reconstructions to restore quadriceps function that have been described with variable outcomes. We
describe a simple technique that employs a single gracilis functional muscle transfer to replace essential quadriceps
function.

Methods: This is a case series describing the use of either a free or pedicled single gracilis muscle to restore
quadriceps function following sarcoma resection.

Results: Four patients underwent an anterior compartment sarcoma resection that resulted in a large segmental
defect and/or denervation of all four quadriceps muscles such that no quadriceps function would remain without
reconstruction. All four patients underwent a functional reconstruction using a single gracilis. Three of the living
patients achieved British Medical Research Counsel Grade 4 strength, can achieve full knee extension, are able to

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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