23395 Muscle transfer, any type, shoulder or upper arm; single

Name of the Procedure:

Muscle Transfer, Any Type, Shoulder or Upper Arm; Single

• Common Name: Muscle Transfer
• Medical Term: Myocutaneous Flap Transfer

Summary

Muscle transfer involves moving a muscle from one part of the body to another to restore function, usually following an injury or surgical removal of tissue. In the case of the shoulder or upper arm, the procedure aims to regain movement and strength.

Purpose

This procedure is performed to address:

• Loss of muscle function due to nerve damage, trauma, or surgical removal of muscle tissue.
• The goal is to restore muscle function, improve range of motion, and strengthen the affected area.

Indications

• Patients with brachial plexus injuries.
• Patients who have experienced muscle paralysis or severe weakness.
• Conditions such as post-polio syndrome or traumatic injuries rendering muscle transfer necessary.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Medications may need to be adjusted, especially blood thinners.
• Preoperative diagnostic tests such as MRI or EMG (electromyography) may be required to assess muscle and nerve function.

Procedure Description

1. Anesthesia: General anesthesia is typically administered.
2. Incision and Muscle Identification: A surgical incision is made to access the donor muscle.
3. Dissection: The selected muscle is carefully detached, preserving its blood supply and nerves whenever possible.
4. Transfer and Attaching: The muscle is then transferred to the recipient site in the shoulder or upper arm and surgically attached to provide the desired function.
5. Closure: Incisions are closed using sutures, and sterile dressings are applied.

Tools and Equipment:

• Surgical instruments for dissection and suturing.
• Microsurgical tools for nerve and blood vessel connections.

Duration

The procedure usually takes between 2 to 4 hours, depending on its complexity.

Setting

This procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Lead Surgeon (typically an orthopedic or plastic surgeon)
• Surgical Assistants
• Anesthesiologist
• Surgical Nurses

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma formation.
• Nerve damage.
• Blood clots.
• Failure of the muscle transfer.

Benefits

• Restoration of muscle function.
• Improved range of motion and strength in the shoulder or upper arm.
• Potentially significant improvement in quality of life within a few weeks to months.

Recovery

• Postoperative care involves pain management often through medication.
• Physical therapy is crucial for rehabilitation and can start within a few days to weeks.
• Recovery time varies but generally ranges from several weeks to a few months.
• Patients may need follow-up appointments to monitor their progress and address any complications.

Alternatives

• Physical therapy alone for less severe cases.
• Nerve grafting or nerve transfer for some types of nerve injuries.
• Orthopedic devices or braces to assist in movement.

Patient Experience

• Patients may experience varying levels of pain, managed through medication.
• Discomfort and swelling at the surgical site are common.
• Physical therapy sessions will be essential for optimal recovery and function restoration.
• Activity restrictions will be in place during the early recovery phase to ensure proper healing.