Arterial supply to the soleus muscle: an anatomical study with emphasis on its application in the pedicle flap surgery

Prathapamchandra, Vani; Prabhu, Latha V.; Pai, Mángala M.; Murlimanju, B. V.; Vadgaonkar, Rajanigandha

doi:10.1007/s00276-015-1485-9

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…Owing to the less bulkiness, the medial Hemi-soleus muscle ap is cosmetically superior to the full soleus muscle ap, which happens to be bulkier. 4,10,11 In this study, all the flaps survived. Ahmad I et al 8 in their series of 40 cases, reported a complete loss of two flaps.…”

Section: Discussionmentioning

confidence: 70%

Proximally Based Medial Hemi-Soleus Muscle Flap Employed For Moderate-Sized Pretibial Defects of the Middle Third of the Leg

Saaiq

Ullah

2023

J Gandhara Med Dent Sci

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OBJECTIVES This study was undertaken to document the clinical indications and outcome of proximally based medial Hemi-soleus muscle flap for coverage of moderate-sized complex pretibial defects of the middle third of the leg. METHODOLOGY This descriptive case series was conducted at the Department of Plastic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Burn & Trauma Center, Hayatabad, Peshawar, over five years. (i.e., from November 01, 2016, to December 31, 2021). It included all adult patients of either gender whose complex pretibial wounds of the middle third leg were managed with proximally based medial Hemi-soleus muscle flaps. RESULTS The mean age was 31.40±9.83 years, ranging between 19-47 years. All the patients had complex post-traumatic defects secondary to road traffic accidents. There were 9(33.3%) patients with minor defects (i.e., measuring ≤2×2 cm2), whereas 18(66.6%) patients had medium-sized defects (i.e., ≥2×2 cm2 and ≤7×5 cm2). Their hospital stay ranged between 9-15 days with a mean stay of 11.92±3.1 days. All the flaps (100%) survived. Partial skin graft loss was encountered among three patients (n=3;11.1%). CONCLUSION The study provides a good evidence base regarding the usefulness of the flap in managing complex defects of the leg. It is recommended to carry out similar studies internationally. These should help improve our findings and come up with further refinements.

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Section: Discussionmentioning

confidence: 70%

Proximally Based Medial Hemi-Soleus Muscle Flap Employed For Moderate-Sized Pretibial Defects of the Middle Third of the Leg

Saaiq

Ullah

2023

J Gandhara Med Dent Sci

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“…However, a surprising finding was that gastrocnemius necrosis was not the risk factor for poor ankle function in our series. This can be explained by the compensatory results of soleus and plantar flexor muscles and the patients' low demand for ankle function [ 32 ]. In fact, there is no existing evidence about whether gastrocnemius artery repair contributes to lower functional outcomes in these patients.…”

Section: Discussionmentioning

confidence: 99%

Five-year outcomes of trauma-specific function in patients after acute blunt popliteal artery injury: a matched cohort analysis

Liu

Zhou

2022

J Orthop Surg Res

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Background Few studies focus on the trauma-specific functional outcomes after surgical revascularization and risk factors contributing to poor outcomes in patients with acute blunt popliteal artery injury (PAI). The objective of this study was to investigate the long-term trauma-specific functional outcomes in patients with acute blunt PAI and identify the associated risk factors. Methods There were 36 patients with acute blunt PAI who require surgical revascularization at a national trauma center of West China Hospital of Sichuan University between March 2010 and April 2019. After propensity matching, each patient was matched to one patient who did not have a concomitant vascular injury in control cohort. Functional outcomes were assessed with trauma-specific functional scores, physical examination of range of motion, nerve functional status and knee stability. A logistics regression model was established to determine the independent risk factors. Results The 5-year (range 2–10 years) follow-up showed that 22 patients (22/36, 61.1%) had functional deficit due to limited activity or chronic neurological symptoms. Patients in vascular cohort had significantly decreased FIM score and AHFS score compared with matched patients without vascular involvement (P = 0.003 and P < 0.001), whereas there was no statistically significant difference in KSS (P = 0.136). Spearman correlation analysis of functional scores in vascular cohort showed that the FIM score was positively correlated with AHFS score (r = 0.926, P < 0.001), but not correlated with the KSS (r = − 0.007, P = 0.967). Additionally, there was significant difference in the range of motion of ankle between two groups (P < 0.001 and P = 0.034). Logistic regression analysis further demonstrated nerve injuries and compartment syndrome were risk factors for poor ankle function after surgery (OR 22.580, P = 0.036 and OR 12.674, P = 0.041). Conclusion Most patients who sustained blunt PAI had significant functional deficit associated with limited activity and chronic neurological symptoms of ankle and foot, and poor functional outcomes were related to nerve injury and compartment syndrome. Therefore, early and effective decompression for compartment syndrome remains the only potentially modifiable risk factor for improving functional outcomes following PAI.

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“…Distally, the minor pedicles are located between 6–7 cm and 11–13 cm proximal to the medial malleolus [8] . Prathapamchandra et al [9] studied 38 adults lower limbs and found that the mean distance of the last pedicle of a posterior tibial artery that supplies the distal part of medial hemisoleus is 29.9 ± 4.7 cm from the imaginary horizontal line that crosses the head of the fibula at the level of the most proximal attachment of soleus muscle, with the range of 20.1–37.5 cm. Some anatomical variations do exist.…”

Section: Discussionmentioning

confidence: 99%

Distally based hemisoleus flap for soft tissue defect closure following chronic osteomyelitis of the distal tibia: A case report

Johan

Nong

Saleh

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Chronic osteomyelitis often needs extensive debridement that leaves a gap and needs soft tissue reconstruction procedure. The use of pedicled versus free flap to reconstruct soft tissue following surgical debridement has long been debated. Pedicle flap is more favored by many surgeons for the distal third tibia, mainly due to its lower failure rate. Case presentation We report a 33-year-old man with eight years of chronic osteomyelitis treated with surgical debridement at the distal third tibia, leaving a 5 cm × 6 cm soft tissue defect with exposed bone. Against the common preference, we performed a distally based hemisoleus flap (pedicled flap) covered with a split thickness skin graft. No signs of flap/graft rejection were observed during follow-up, and the patient was able to return to work four months following the surgery. No limitation in patient's daily activity upon two years follow up. Clinical discussion Preservation of critical perforators is essential during the elevation of the flap. The knowledge and application of the vascularity and angiosome principles are crucial in designing this type of flap, as some anatomical variations do exist. Meticulous tissue handling is required to support the basic knowledge of the lower limb vascular system. Conclusion Distally based hemisoleus flap is a reasonable option for soft tissue defect following chronic osteomyelitis of the distal tibia.

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Arterial supply to the soleus muscle: an anatomical study with emphasis on its application in the pedicle flap surgery

Cited by 7 publications

References 15 publications

Proximally Based Medial Hemi-Soleus Muscle Flap Employed For Moderate-Sized Pretibial Defects of the Middle Third of the Leg

Proximally Based Medial Hemi-Soleus Muscle Flap Employed For Moderate-Sized Pretibial Defects of the Middle Third of the Leg

Five-year outcomes of trauma-specific function in patients after acute blunt popliteal artery injury: a matched cohort analysis

Distally based hemisoleus flap for soft tissue defect closure following chronic osteomyelitis of the distal tibia: A case report

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