An anatomical study of the pectoralis major muscle as related to functioning free muscle transplantation.

The prerequisites for a functioning free muscle transplant are reviewed. A method for studying the anatomy of the pectoralis major muscle is presented, giving special attention to the detail of the neurovascular structures. Fifteen meticulous dissections, documented by sketches and photographs, provide the data base. This work is summarized in Table I and Figure 3. The variability is stressed in Table II. None of the variations observed preclude the use of the inferior four-fifths of the sternocostal muscle as a functioning free muscle transplant. The length and bulk of this muscle are advantages for its use in replacing forearm flexors. The multiple innervations may be an advantage or disadvantage, depending on the availability of the motor nerves in the recipient site. The time-consuming dissection is a disadvantage. With this knowledge, the reconstructive surgeon can assess the advisability of using the pectoralis major muscle as a functioning free muscle transplant.