Maximizing the Reach of the Pedicled Gastrocnemius Muscle Flap

Lamaris, Gregory A.; Carlisle, Michael P.; Durand, Paul; Couto, Rafael A.; Hendrickson, Mark

doi:10.1097/sap.0000000000000796

Cited by 10 publications

(12 citation statements)

References 13 publications

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“…However, this technique could only increase the size and reach of the flap by a few centimetres. Lamaris et al in their cadaveric study found that the reach could be increased further when a posterior midline incision was used compared to medial incision 8 . The average increase in reach was 2.02cm and total surface area of 20.3cm 2 .…”

Section: Discussionmentioning

confidence: 99%

Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice

Yusof

Ahmad-Alwi

2019

Malays Orthop J

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Introduction: Large wounds in the leg require combination of local flaps or free flap for wound coverage. Gastrocnemius musculocutaneous flap (GMCF) allows a large wound to be covered by a single local flap. However, the conventional GMCF is often associated with donor site morbidity where the exposed soleus raphe causes poor uptake of the skin graft. Islanding the skin on the muscles allows the donor site to be closed primarily, thus avoiding the donor site morbidity. Materials and Methods: Medical records of twelve patients who underwent islanded GMCF surgery from 2004 till 2018 were reviewed retrospectively. Results: The mean age was 31 years old. Eight cases were with open fracture of the tibia, two degloving injury exposing the patella, one open fracture of patella and necrotising soft tissue infection. The wound size ranged from 12cm 2 to 120cm 2 . All flaps survived. Three patients required skin grafting at the donor site while in the rest the donor sites were able to be closed primarily. Four patients developed deep infection, one healed after vacuum dressing, one after bone transport and one after split thickness skin graft. One patient ended up with below knee amputation after developing chronic osteomyelitis of the tibia. Conclusion: Islanded gastrocnemius musculocutaneous flap is an effective simple alternative for coverage of large soft tissue defects from the knee to half of the leg distally with minimal donor site morbidity. Aggressive debridement of unhealthy tissue is necessary to prevent infection following wound coverage with this flap.

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Section: Discussionmentioning

confidence: 99%

Outcome of Islanded Gastrocnemius Musculocutaneous Flap in Orthopaedic Practice

Yusof

Ahmad-Alwi

2019

Malays Orthop J

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“…The medial gastrocnemius muscle flap is considered a simple and safe method and is commonly used to reconstruct defects around the knee and proximal leg (9). Typically, the reach of the muscle is restricted to just below the knee, so the release of the medial femoral condyle and scoring of the deep fascia is used to increase the reach (10).…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of complex knee wounds with a distally based gracilis flap and gastrocnemius myocutaneous flap: A case report

Kwon

Lee²,

Kim³

et al. 2023

Front. Surg.

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A gastrocnemius muscle flap is a versatile option for covering the proximal one-third of the lower leg and around the knee. On the other hand, it is of limited use in patients with short gastrocnemius muscle or insufficient volume. The authors present a case in which a knee soft tissue defect occurred in a very thin patient and was reconstructed using a gastrocnemius myocutaneous flap and a distally based gracilis flap as a supplementary flap.

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“…• The posterior midline incision is placed directly between the medial and lateral muscle bellies, extending from the distal end of the muscle bellies through the popliteal fossa. A recent cadaver study found a safer dissection and greater muscle reach with the posterior midline approach 8 . However, the medial approach is more commonly utilized, given the relative ease of performing it in a supine position.…”

Section: Contraindicationsmentioning

confidence: 99%