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Tissue coverage for exposed vascular reconstructions (grafts)
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Kaitlyn Rountree, Vikram Reddy, Sachinder Singh Hans
The gastrocnemius muscle is the most superficial muscle of the posterior lower leg. It is responsible for flexion of the knee and plantar flexion of the foot. Comprised of two heads, the medial head originates from the posterior surface of the distal femur just superior to the medial condyle and the lateral head arises from the upper posterolateral surface of the lateral femoral condyle. The muscle fibers converge distally and merge with fibers of the deeper soleus muscle, and insert on the calcaneus as the Achilles tendon. The lateral and medial sural arteries supply their respective heads of the gastrocnemius muscle, entering superiorly as branches from the popliteal artery. The unique vascular supply allows for independently pedicled flaps without the need for microvascular anastomosis.29
Lower Extremity Surgical Anatomy
Published in Armstrong Milton B., Lower extremity Trauma, 2006
Latham Kerry, Baez Marcelo Lacayo, Armstrong Milton B., Arias Efrain
3. The sural arteries, which are two, and are behind the knee joint supplying the gastrocnemius, soleus, and plantaris muscles; the superior genicular arteries, which arise from the popliteal and curve around, proximal to both femoral condyles to the anterior area of the knee. Smaller branches of the superior genicular arteries are also relevant.
An early complication in the donor site of the medial sural artery perforator flap: necrosis of the medial head of gastrocnemius
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Hui-Ju Tsou, Chih-Peng Tu, Yu-Fan Chen, Wen-Teng Yao
The gastrocnemius muscle is now considered a Mathes and Nahai type II muscle [7,8]. The proximal part of the muscle is supplied by the medial and lateral sural arteries, whereas the distal part of the muscle receives branches from the posterior tibial artery and the peroneal artery. In harvesting the MSAP flap, the vascular pedicle is dissected from the medial sural artery, which originates from the popliteal vessels. Thus, even if there are small branches supplying the medial head of gastrocnemius muscle, which take off before the medial sural artery enters the muscle [7], they will be sacrificed. However, the medial gastrocnemius muscle could survive even after division of medial sural artery pedicle, owing to adjacent angiosomes. Some studies suggest that the possibility of muscle ischaemia after sacrifice of even the entire medial sural artery should thus be remote [1,2,9].