Tissue coverage for exposed vascular reconstructions (grafts)
Sachinder Singh Hans, Mark F. Conrad in Vascular and Endovascular Complications, 2021
The rotational gastrocnemius flap is a suitable source of viable tissue coverage of below-knee vascular bypasses, and is considered well within the capability of a vascular surgeon. More extensive or re-do flaps may necessitate the expertise and assistance of a plastic surgeon. As the most superficial muscle in the posterior compartment of the lower leg, the bellies of the gastrocnemius are readily identifiable and usually lie within the existing surgical field or wound. The medial head of the gastrocnemius is the traditional work horse of anterior knee and proximal tibial coverage; it is longer than its lateral counterpart and can be harvested without risk to the superficial peroneal nerve. The gastrocnemius can be harvested to suit the needs of the surgeon, with either the medial or lateral heads independently or together.
Podiatric Medicine and the Painful Heel
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Pain from plantar fasciitis can be noted to increase when there is a decrease in the flexibility of the gastrosoleus (triceps surae) complex at the calf area. The gastrocnemius muscle assists in plantar flexion of the foot and in knee flexion; the soleus muscle assists in plantar flexion of the foot. The triceps surae sends a plantar attachment under the heel and into the plantar fascia. However, remember that when the plantar fascia is stretched, inversion of the heel occurs to a slight degree. Peroneal muscles (evertors of the foot) can be involved. These muscles are working harder to perform their function. As a result, it is easy to note that evaluation cannot always be contained to the heel itself. Soft tissue attachments to the heel and around the heel must be assessed.
Lower Extremity Surgical Anatomy
Armstrong Milton B. in Lower extremity Trauma, 2006
The gastrocnemius muscle provides force and propulsion in running, jumping, and walking. Along with the soleus it is the chief plantar flexor of the foot. The gastrocnemius is also a knee flexor. It is a 20 × 8 cm2 muscle that is type I. It originates on the medial condyle of the femur and the lateral head of the femoral condyle (which often contains a sesamoid bone in the tendinous origin of the head) where it forms the inferior medial and lateral border of the popliteal fossa. The medial head is larger and descends more distally than the lateral head. The fleshy muscle descends until midcalf where it inserts into a broad aponeurosis and inserts into the calcaneous via the tendon calcaneous. The plantaris muscle can be identified in most individuals separating the gastrocnemius and soleus muscles. It is innervated by the tibial nerve and is vascularized by the sural arteries. The skin over the medial gastrocnemius receives sensory innervations from the saphenous nerve, and laterally the sural nerve innervates the skin over the lateral gastrocnemius. Either or both heads of the gastrocnemius are expendable if the soleus is intact. The gastrocnemius based superiorly is used to cover the knee and upper third tibia defects. Distally based flap can be used to cover middle third leg defects.
Use of acellular dermal matrix in peripheral nerve reconstruction: an experimental study on rat sciatic nerve defect
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Fatih Ceran, Ozgur Pilanci, Asuman Ozel, Gul Ilbay, Rukiye Karabacak, Mehmet Kanter, Konuralp Ilbay, Samet Vasfi Kuvat
After electrophysiologic recording, a longitudinal incision parallel to the fibers of the gastrocnemius muscle and the Achilles tendon was made. The gastrocnemius muscle was laid open through the dissections at both ends of the muscle in the femoral region, and along the Achilles tendon near the heel at the distal aspect. The muscle was excised through the incisions made at the origin and insertion points. Since the soleus muscle would not be included in the weight measurement, it was also resected. The excised gastrocnemius muscle was weighed using a precision balance and the result was compared to the muscle mass in the intact leg, which served as the control group. The gastrocnemius weight ratios were calculated according to the following formula:
The Influence of Contraction Types on the Relationship Between the Intended Force and the Actual Force
Published in Journal of Motor Behavior, 2020
Takeshi Miyamoto, Tomohiro Kizuka, Seiji Ono
The isometric force at the ankle joint in plantar flexion was measured using a customized dynamometer. This dynamometer consisted of a 15 × 30 cm footplate which is attached to a load cell transducer (LUR-A-1KNSA1; Kyowa Electronic Instruments, Tokyo, Japan). The reason for using the plantar flexion of the ankle joint was that there is no study to examine the relationship between the intended force and the actual force using the isometric plantar flexion, and the plantar flexion is comparable with dynamic movements such as jumping movements. The subjects were seated and their right thigh and ankle were fastened to the dynamometer. The knee and the ankle joint were placed at an angle of 90˚. The arms were folded across the chest during testing (Figure 1). The agonist for the ankle plantar flexion is the triceps surae (i.e., medial and lateral gastrocnemius and soleus). However, because the gastrocnemius is a biarticular muscle that acts both as a plantar flexor and a knee flexor, it is less involved in ankle plantar flexion when the knee is flexed 90˚. Therefore, EMG activity was recorded by surface electrodes (Bagnoli-2, Delsys, Boston, Massachusetts, USA) from the soleus of the right leg in this study. A reference electrode was placed over the head of fibula. Prior to application of electrodes, the skin was prepared using paste and alcohol to reduce skin impedance. The EMG signal was amplified 1000 times. The detected force and EMG signals were digitized at 1 kHz using Micro 1401-2 (Cambridge Electronic Design, Cambridge, UK) (Figure 2).
Muscle Strength Training Alters Muscle Activation of the Lower Extremity during Side-Step Cutting in Females
Published in Journal of Motor Behavior, 2020
Jiyoung Jeong, Dai-Hyuk Choi, Yongnam Song, Choongsoo S. Shin
Both biceps femoris and gastrocnemius muscle activation patterns during cutting maneuver changed in ways that may decrease the ACL injury risk after strength training. According to a recent cadaveric study that investigated the roles of the medial hamstring (i.e., semitendinosus and semimembranosus) and lateral hamstring (i.e., biceps femoris) in ACL strain, the contraction of the lateral hamstring can lead to a large reduction in the ACL strain while contraction of the medial hamstrings has little effect on ACL strain reduction from 0° to 90°of knee flexion positions (Guelich, Xu, Koh, Nuber, & Zhang, 2016). It also has been reported that the gastrocnemius is a knee flexor, but it contributes to the loading of the ACL (Adouni, Shirazi-Adl, & Marouane, 2016; Mokhtarzadeh et al., 2013). A large ACL strain was found when gastrocnemius was activated alone or combined with other muscles, and the gastrocnemius muscle is an antagonist of the ACL, particularly when the knee is near extension (Fleming et al., 2001; O'Connor, 1993). Thus, strength training increased biceps femoris muscle activity and reduced gastrocnemius muscle activity, which can be beneficial for reducing the ACL injury risk during side-step cutting.
Related Knowledge Centers
- Achilles Tendon
- Femur
- Plantaris Muscle
- Soleus Muscle
- Tibia
- Triceps Surae Muscle
- Calcaneus
- Posterior Compartment of Leg
- Knee
- Calf