Retalho cutâneo das artérias perfurantes do músculo gastrocnêmio medial: estudo anatômico

Torres, Luciano Ruiz; Teixeira, William Gemio Jacobsen; Setani, Eliana Ogassavara; Wei, Teng Hsiang; Zumiotti, Arnaldo Valdir

doi:10.1590/s1413-78522007000100008

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…The results of our anatomic study were similar to studies by Torres et al and Otani et al which place the distal most medial and lateral gastrocnemius muscle perforators at 16.3 and 17.5 cm distal to the popliteal crease or the intercondylar line. 11,12 Regarding the number of perforators arising from the lateral head our results were different from the study by Otani et al which did not find any cutaneous perforator in 57% of the cases while we found at least 1 cutaneous perforator from the lateral head in 100% of the cadaveric dissections…”

Section: Discussioncontrasting

confidence: 99%

Anatomical study of perforators of posterior upper and middle third of leg to assess feasibility of combined gastrocnemius flaps

Kapoor¹,

Chattopadhyay²,

Nath³

et al. 2020

IJCAP

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A common problem seen in the plastic surgery referrals for management of fractures of the leg is the loss of tissue cover over the tibia. This is probably due to the fact that the anterior border of tibia is subcutaneous and prone to loss of tissue following road traffic accidents. To solve this problem a large amount of tissue is required which is mostly available on the posterior aspect of the leg. In order to move this tissue without risk of necrosis the flap must be supplied by an adequate number of perforator vessels. Therefore we decided to study the anatomy of perforators of the sural artery along with the posterior tibial and peroneal system so that the anatomical basis of a combined flap may be defined. Materials and Methods: We performed cadaveric dissection in 20 legs to note the location of the proximal and distal most perforators arising from the sural, peroneal and posterior tibial arteries on the posterior aspect of the leg extending from the intercondylar line up to 8cm proximal to the medial an lateral malleolus. The area of medial belly of gastrocnemius with the adjacent posterior tibial perforators was designated as the medial flap and the area over lateral belly of gastrocnemius with adjacent peroneal perforators was designated as lateral flap. Results: In the area defined as the medial flap we found an average of 2.5 perforators arising from the medial sural artery and 1.7 arising from the posterior tibial artery. In the medial flap the distal most perforator was the posterior tibial septocutaneous perforator, which was at an average 23.3cm from the intercondylar line, around 6.8 cm farther away from the distal most medial sural perforator. In the lateral flap region we found an average of 1.7 lateral sural perforators along with 1.5 peroneal perforators. In this flap the distal most perforator was the peroneal septocutaneous, at an average distance of 23.1cm distal to the intercondylar line and at an average of 7.3cm further away from the distal most lateral sural perforator. Conclusion: On examination of the anatomical basis of the combined medial and lateral flap it is possible to raise long flaps of around 25-30 cm, which would be ideal to resurface long defects on the anterior aspect of leg. Raising these flaps with the gastrocnemius muscle in the flap would help to increase the axis of rotation of the flap allowing the flap to move to the anterior aspect of leg and even for resurfacing large defects over the knee.

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Section: Discussioncontrasting

confidence: 99%

Anatomical study of perforators of posterior upper and middle third of leg to assess feasibility of combined gastrocnemius flaps

Kapoor¹,

Chattopadhyay²,

Nath³

et al. 2020

IJCAP

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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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“…34 In the subsequent clinical experience, increasingly larger skin islands were lifted from the flap without presenting damage. Accordingly, the muscle becomes, for the most distant defects, a "carrier" of vascularized skin.…”

Section: Methodsmentioning

confidence: 99%

Transposição do enxerto vascularizado da fíbula pro fêmur diafisário sem microanastomoses

Torres¹,

Paganotti²,

Gaiarsa³

et al. 2010

Acta ortop. bras.

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Retalho cutâneo das artérias perfurantes do músculo gastrocnêmio medial: estudo anatômico

Cited by 6 publications

References 13 publications

Anatomical study of perforators of posterior upper and middle third of leg to assess feasibility of combined gastrocnemius flaps

Anatomical study of perforators of posterior upper and middle third of leg to assess feasibility of combined gastrocnemius flaps

Use of local muscle flaps to cover leg bone exposures

Transposição do enxerto vascularizado da fíbula pro fêmur diafisário sem microanastomoses

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