Ebisudani Shogo, Inagawa Kiichi, Suzuki Yoshinori, Osugi Ikuko
Department of Plastic and Reconstructive Surgery, Kawasaki Medical School, Okayama, Japan.
Plast Reconstr Surg Glob Open. 2020 Nov 23;8(11):e3201. doi: 10.1097/GOX.0000000000003201. eCollection 2020 Nov.
Inferiorly based gastrocnemius muscle flaps have been successfully used to cover soft tissue defects of the middle third of the leg. This is done especially in older patients or patients with major complications where operative time should be limited. We aimed to determine the gastrocnemius muscle length that can be safely used for preparing inferiorly based muscle flaps.
We performed angiographies and dissection to investigate the numbers and distribution of the communicating arterial branches between the medial and lateral heads of the gastrocnemius muscle, and the perforating arterial branches of the medial sural artery from the soleus to the gastrocnemius muscles on 18 legs of preserved cadavers.
The lengths of the gastrocnemius heads were approximately 10 cm, and the communicating arterial branches of the gastrocnemius muscle also were located at approximately 10 cm from the gastrocnemius head. The perforating arterial branches from the soleus muscle to the gastrocnemius muscle were also located at approximately 10 cm from the gastrocnemius head.
Communicating arterial branches of the gastrocnemius muscle were found in all cadavers. To the best of our knowledge, no other study has focused on investigating the perforating arterial branches that supply the gastrocnemius from the soleus muscle. Our study indicates that the entire gastrocnemius muscle can be safely used in reconstruction surgeries.
以腓肠肌下极肌瓣已成功用于覆盖小腿中1/3的软组织缺损。尤其适用于老年患者或有严重并发症且手术时间应受限的患者。我们旨在确定可安全用于制备以腓肠肌下极肌瓣的腓肠肌长度。
我们对18条保存尸体的下肢进行血管造影和解剖,以研究腓肠肌内侧头和外侧头之间交通动脉分支的数量和分布,以及比目鱼肌至腓肠肌的腓肠内侧动脉穿支。
腓肠肌头的长度约为10厘米,腓肠肌的交通动脉分支也位于距腓肠肌头约10厘米处。比目鱼肌至腓肠肌的穿支动脉分支也位于距腓肠肌头约10厘米处。
在所有尸体中均发现了腓肠肌的交通动脉分支。据我们所知,没有其他研究专注于调查比目鱼肌供应腓肠肌的穿支动脉分支。我们的研究表明,整个腓肠肌可安全用于重建手术。