THE TRANSPLANTATION OF MUSCLES.

Press, Volume LV, Issue 9988, 18 March 1898, Page 7

THE TRANSPLANTATION OF MUSCLES.

The ingenious method of remedying loss of power and deformity from paralysis of certain muscles by attaching their tendons to those of others is of recent growth. In the Boston Medical and Surgical Journal of November 11th, 1897, Dr Joel E. Goldhurst describes an important advance on this method made by American surgeons in the last few years—the dissection ont of the muscles and their direct re-attachment to others. In a large number of cases of infantile paralysis the sartorius escapes. Being a flexor of the knee its action is useless or harmful when extension la lost from paralysis of the quadriceps. To improve the limb and restore extension Dr. Goldhurst transplants the sartorious and attaches it to the quadriceps tendon just above the patella. Hβ has operated on five patients with marked improvement in three and failure in two, whioh he attributes to imperfect methods of attaching the muscle. He operates as follows. A six-inch longitudinal incision is made on the inner side of the thigh with the middle opposite the top of the patella. The satorions is dissected out, cut off at its insertion, brought forward and attaohed to the muscular fascia just above and a little to the inner side of the patella. The attachment must be made firmly by splitting the fascia and drawing the muscle through, so that it beoomes adherent to both inner and outer surfaces. Eangarob tendon is used for sutures, being -the best material. The wound is then closed and the whole thigh is bandaged, and finally a plaster-of-paris bandage or a long splint is applied. The patient is kept recumbent for iwo weeks at least, gentle motion is commenced at the end of three weeks, and the plaster is entirely omitted at the end of from five to six weeks. One case was that of a woman, aged twentytwo years, paralysed from early childhood, who had no power of extension or of bearing weight on the limb unless the knee was fixed artificially, and who had a flail-like leg, "flinging gait, and need a" crutch constantly. After the operation, though still somewhat lame, chiefly from weakness of the foot and ankle, the meobanical difficulty at the knee and the gait' were almost entirely corrected, the leg was extended normally, and she was able to do housework.— Lancet.