Estudo anatômico do músculo gastrocnêmio medial visando transferência muscular livre funcional

Moraes, Frederico Barra de; Paranahyba, Rodrigo Marques; Oliveira, Emanoel de; Kuwae, Mário Yoshihide; Rocha, Valney Luís da

doi:10.1590/s0102-36162007000800006

Cited by 5 publications

(4 citation statements)

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“…The gastrocnemius and soleus muscles, being vascularized predominantly in their proximal regions, allow the rotation about the axis of the pedicle (good arc of rotation), without compromising vitality. They thus offer a good option for bone and soft tissue coverage of the Table 1 Table 1 Table 1 Table 1 Table 1 proximal and middle thirds of the leg, being the most used, usually individually [8][9][10][11][12][13][14][15][16] . In some situations, one may employ the soleus associated with one of the belies of the gastrocnemius 17 .…”

Section: Results Results Results Resultsmentioning

confidence: 99%

Use of local muscle flaps to cover leg bone exposures

Dávila¹,

Franco

d'Avila

et al. 2014

Rev. Col. Bras. Cir.

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Objective: To evaluate the use of the medial gastrocnemius muscle and/or soleus muscle flaps as surgical treatment of the leg bone exposure.Methods: We retrospectively analyzed the medical records of patients undergoing transposition of the medial gastrocnemius and / or soleus for treating exposed bone in the leg, from January 1976 to July 2009, gathering information on epidemiological data, the etiology the lesion, the time between the initial injury and muscle transposition, the muscle used to cover the lesion, the healing evolution of the skin coverage and the function of the gastrocnemius-soleus unit.Results: 53 patients were operated, the ages varying between nine and 84 years (mean age 41); 42 were male and 11 female. The main initial injury was trauma (84.8%), consisting of tibia and / or fibula fracture. The most frequently used muscle was the soleus, in 40 cases (75.5%). The rank of 49 patients (92.5%) was excellent or good outcome, of three (5.6%) as regular and of one (1.9%) as unsatisfactory.Conclusion: the treatment of bone exposure with local muscle flaps (gastrocnemius and/or soleus) enables obtaining satisfactory results in covering of exposed structures, favoring local vascularization and improving the initial injury. It offers the advantage of providing a treatment in only one surgical procedure, an earlier recovery and reduced hospital stay.

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Section: Results Results Results Resultsmentioning

confidence: 99%

Use of local muscle flaps to cover leg bone exposures

Dávila¹,

Franco

d'Avila

et al. 2014

Rev. Col. Bras. Cir.

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“…In group 1, the MG FMT was performed with the following steps: (1) median curvilinear longitudinal incision, which starts 8 cm proximal to the popliteal crease, extends distally up to 10 cm proximal to the medial malleolus; (2) dissection of the intermuscular septum between the two gastrocnemius bellies, laterally displacing the small saphenous vein and the sural nerve, individualizing the muscle and neurovascular structures of the popliteal fossa; (3) the origin of the MG is then severed from the femoral medial condyle and the medial sural neurovascular bundle is dissected and clamped for resection, in its longest extension, 1 cm proximal to the joint; (4) identification of the sciatic, medial popliteal and tibial nerve (from the roots of L4–L5/S1–S3 of the lumbosacral plexus), from which the branch to the MG originates, called medial sural nerve (MSN), according to the anatomical model described by Moraes et al 7 (5) identification of the number of arterial and venous branches that arrive at the MG pedicle, as well as the crossing of the small saphenous vein over the MSN, which may hinder its dissection; (6) deltopectoral incision and subcutaneous dissection in the upper limb to where one intends to transfer the MG for biceps function with dissection of the artery, the thoracodorsal vein and the cephalic vein; (7) MG FMT for elbow flexion, with fixation of the proximal ventral region at the proximal end of the humerus through the bone window and fixation with cortical screws in the distal region of the distal stump of the biceps tendon; (8) microanastomosis of the arterial branch of the MG in the thoracodorsal artery; the veins were attached, one in the thoracodorsal vein and another in the cephalic vein; (9) the microanastomosis of the MG MSN was carried out in different peripheral branches, with neurotizations to the musculocutaneous from the ulnar, intercostal or accessory nerves. 1 , 8 , 9 …”

Section: Methodsmentioning

confidence: 99%

Evaluation of elbow flexion following free muscle transfer from the medial gastrocnemius or transfer from the latissimus dorsi, in cases of traumatic injury of the brachial plexus

Moraes

Kwae

Silva

et al. 2015

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveTo compare the gain in elbow flexion in patients with traumatic injury of the brachial plexus following muscle transfer from latissimus dorsi with the gain following free muscle transfer from the medial belly of the gastrocnemius.MethodsThis was a retrospective study in which the medical files of a convenience sample of 13 patients operated between 2000 and 2010 were reviewed. Group 1 comprised seven patients who underwent transfers from the gastrocnemius and group 2 (controls) comprised six patients who underwent transfers from the latissimus dorsi. The following functions were evaluated: (1) range of motion (ROM) of elbow flexion, in degrees, using manual goniometry and (2) grade of elbow flexion strength, using a muscle strength scale. Satisfactory results were defined as: (1) elbow flexion ROM ≥ 80° and (2) elbow flexion strength ≥ M3. The Fisher exact and Kruskal–Wallis tests were used (p < 0.05).ResultsThe patients’ mean age was 32 years (range: 17–56) and 72% had been involved in motorcycle accidents. Elbow flexion strength ≥ M3 was observed in seven patients (100%) in group 1 and in five patients (83.3%) in group 2 (p = 0.462). None of the patients presented M5, and one patient (16.7%) in group 2 had a poor result (M2). Elbow flexion ROM with a gain ≥ 80° (daily functions) was found in six patients (86%) in group 1 and in three patients (50%) in group 2 (p = 0.1).ConclusionThe patients in group 1 had greater gains in strength and ROM than did those in group 2, but without statistical significance. Thus, transfers from the gastrocnemius become a new surgical option, if other techniques cannot be used.

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“…As dissecções do MGM foram realizadas com instrumental apropriado para cirurgia de mão e microcirurgia, segundo o que foi descrito por Moraes et al (13) .…”

Section: Métodosunclassified