Whitney T M, Heckler F R, White M J
Department of Plastic and Reconstructive Surgery, Lahey Clinic, Burlington, MA 01805, USA.
Ann Plast Surg. 1995 Apr;34(4):415-9. doi: 10.1097/00000637-199504000-00014.
The gastrocnemius muscle flap has gained wide acceptance as a reconstructive technique for management of wounds of the knee and proximal tibia. The use of the muscle as a pedicle flap to the distal and middle femur has not been well quantified, and the proximal rotation arc has been underestimated. We report the use of the island gastrocnemius pedicle flap to reach two femur defects 21 and 26 cm above the joint line, achieved by taking advantage of the favorable location of the vascular pedicle above the joint line and the individual length of the medial gastrocnemius muscle belly. Evaluation of standard arteriograms suggests the location of the medial sural artery pedicle is an average of 32 +/- 14.5 (SD) mm above the inferior border of the femur. All vessel origins were found above the joint line by radiograph. A common sural artery origin was noted in 32% of patients at a mean distance of 35 mm proximal to the joint line. Despite a wide range, 62% of sural artery origins were within 1 cm of an axis drawn through the widest point of the femoral condyles.
腓肠肌肌瓣作为膝关节和胫骨近端伤口的重建技术已被广泛接受。将该肌肉作为带蒂皮瓣用于股骨远端和中段的情况尚未得到充分量化，且其近端旋转弧被低估。我们报告了通过利用关节线上方血管蒂的有利位置和内侧腓肠肌肌腹的个体长度，采用岛状腓肠肌带蒂皮瓣修复关节线以上21厘米和26厘米处的两处股骨缺损。对标准动脉造影片的评估表明，腓肠内侧动脉蒂的位置平均在股骨下缘上方32 +/- 14.5（标准差）毫米处。通过X线片发现所有血管起源均在关节线以上。32%的患者存在腓肠总动脉起源，平均距离关节线近端35毫米。尽管存在较大差异，但62%的腓肠动脉起源位于通过股骨髁最宽点所画轴线的1厘米范围内。
