Gastrocnemius flap: Anatomical study of perforators of posterior upper and middle third of leg

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Article type :

Original Article

Author :

Gazala Shaireen, S S Imran, Mohammed Khaleel Ahmed

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Abstract :

Background: Huge easy nerve limb flaw connecting higher and mid-3rd remains a therapeutic challenge. The objective of this study was to evaluate the effectiveness and versatility gastrocnemius myocutaneous flap cover for post traumatic large defect of greater and mid-3rd of leg. Materials and Methods: As accomplished cadaveric partition in twenty legs to copy the place of the proximal and distal greatest perforators rising since the sural, peroneal and later tibial blood vessel on the later feature of the leg spreading since the intercondylar streak upon eight cm centre of the body to the middle n adjacent a bony projection with a shape likened to a hammer head. The part of middle stomach of gastrocnemius through the end-to-end later tibial a nerve was selected as the mid lap & the area ended adjacent stomach of gastrocnemius with together peroneal a nerve was elected as adjacent flap. Results: In the area definite as the middle flap we originate a regular of 2.4 a nerve arising since the middle sural blood vessel & 1.8 rising since the later tibial blood vessel. In the mid flap the distal greatest a nerve was the later tibial sept cutaneous a nerve, such as a regular 23.2 cm since the notch separates the condyles of the femur line, about 6.8 cm beyond away since the distal greatest mid sural a nerve. Cutting-edge the side fold area, as originate a regular of 1.8 adjacent sural a nerve alongside by 1.6 peroneal blood vessel forming a connection between a deep system and a superficial one. In this lappet the distal greatest blood vessel forming a connection between a deep system and a superficial one was the peroneal septocutaneous, at a normal space of 23.2cm distal to the notch separates the condyles of the femur streak and at a normal of 7.3cm additional missing since the distal greatest adjacent sural blood vessel forming a connection between a deep system and a superficial one. Conclusion: At the time of inspection of the functional base of mutual mid and adjacent flap it is probable to increase extensive flaps of about 25-30 cm, such could be perfect to rise lengthy flaws on the forward feature of leg. Hovering these flaps by the gastrocnemius strength in the flap might support to surge the alliance of revolution of the flap letting the flap to change to the forward phase of leg and uniform for rising great flaws above the lap.

Keyword :

 Gastrocnemius flap, Myocutaneous flap, Posterior tibial artery.
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