The Quantified Human Gracilis-A Guide to Improve Aesthetic and Functional Outcomes

Abstract

Background: A functioning gracilis muscle is considered the ideal flap to improve the functional/aesthetic outcome with minimal donor site morbidity. This graceful and slender muscle with special attributes is increasingly being used for covering soft tissue defects, repair of urogenital fistulas and restoration of anal function. Only some studies describing the quantification of this muscle are available and population attributes of the muscle have not been taken into consideration. The present study quantifies the human gracilis muscle in a North Indian population. Methods: The morphometry of gracilis was studied in 50 inferior extremities obtained from 25 phenol embalmed adult North Indian cadavers with known age and sex. The length and width of the aponeurotic origin, the length of the muscle belly, length of the distal tendon of insertion were measured. The muscle, tendon ratios were derived. Results: The mean estimates for various morphological features of gracilius muscle were standardized for North Indians. All the origins and insertions for the muscle correlated with the standard textbook descriptions. No variation was found from a standard textbook pattern in the present sample. The reconstructive procedures should take the local population profile into consideration. Conclusion:The results will aid the clinician in choosing an appropriate muscle and tendon lengths in surgeries. This definitely will lead to better functional and aesthetic outcomes in restorative procedures.