13.5.5 Gastrocnemius Flap

8/13/2019 13.5.5 Gastrocnemius Flap

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13.5.5 GASTROCNEMIUS FLAP

Ger and Efron - Clin.Orthop - 1970

Indications

• Coverage of defects of the leg and knee

• Easy elevation

• Reliable blood spply

• Elevate t!o parts of the "scle separately

Vascula su!!l"

• #edial and lateral sral arteries$ arising fro" popliteal a

• %cco"panied by "otor nerves

• Each head can be "obilised separately on its o!n nerovasclar pedicle.

• #athes and &ahai 'ype (

#edial )ead

• #ore sed than lateral head$ "scle body is longer$ no risk to co""on peroneal

nerve.

• Rotates to pro*i"al head tibia and ant and "edial aspects of the knee

• (nc arc by + "ltiple transverse incisions in the aponerosis on the deep aspect of

the "scle. Or division of pro*i"al tendon insertion. + then can cover over the

,nction of the pro*i"al and "iddle third of the leg.

ast printed - 1 /var/!!!/apps/conversion/t"p/scratch/202343235.doc


2/8

• %ssoc !ith a skin paddle on the distal part of the "scle and on the distal

aponerosis per"its a longer flap !hich can cover a portion of the "iddle third of theleg. Rotation over the knee is i"proved by decrossing the "scle !ith the tendons ofse"i"e"branoss and gracilis

#o$ to do it%

Pati&nt su!in&' li() in &*t&nal otation. +n&& sli,-tl" l&*&d / o can !osition lat&al

Incision (id cal 0c( )&-ind !ost&o(&dial )od& o ti)ia' cu&d !o*i(all" to t-& !o!lit&al ossa. E*t&ndinto t-i,- i n&&d&d. 2atc- o t-& sa!-&nous &in and n&&. Incis& t-& d&&! ascia in lin& $it- t-& sin

incision. R&tact la,& sin la! $it- t-& a!on&uosis as a as t-& !lan& )&t$&&n t-& 0 -&ads.



3/8

T-& int&(uscula !lan& is d&&lo!&d $it- a in,& )&t$&&n Sol&us and t-& (&dial -&ad at& incision o t-&t-in a!on&uosis. Ot&n t-& !lantais t&ndon is ound in t-is s!ac&. T-& sual n&& is id&ntii&d on t-& !ostas!&ct o t-& ,astocn&(ius. It li&s )&t$&&n t-& 0 -&ads on an a!on&uotic s-&&t and is co&&d )" a t-in

la"& o (uscl& i)&s o( t-& (&dial -&ad. It is diss&ct&d && and &tact&d !ost&iol".



4/8

T-& ac o otation (a" )& inc&as&d )" &l&asin, t-& oi,in o t-& (uscl& o( t-& &(u. T-& sin incision&*t&nd&d o& t-& lo$& !at o t-& t-i,- allo$s t-& &*!osu& o t-& t&ndons o s&(it&ndinosus' satoius

and ,acilis. T-& (&dial -&ad o ,astocn&(ius' isolat&d on its ascula !&dicl& (ust )& !ass&d d&&! to t-&t&ndons o s&(it&ndinosus and ,acilis to ,&t to t-& ant&io as!&ct o t-& n&&.



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4asic anato("



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ast printed - /var/!!!/apps/conversion/t"p/scratch/202343235.doc


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13.5.5 Gastrocnemius Flap