Neurovascular anatomy of sartorius muscle flaps: implications for local transposition and facial reanimation.
BACKGROUND
The sartorius muscle is a superficial muscle of the thigh that possesses highly suitable qualities for many uses in local transposition and free muscle transfer. However, a paucity of description of the neurovascular anatomy of the sartorius has contributed to its infrequent use in these roles.


METHODS
Both human and canine studies were undertaken to delineate the neurovascular anatomy of the sartorius and to determine the role for surgical delay clinically. Fifty-five human cadaveric sartorius muscles and 30 canine cadaveric sartorius muscles underwent angiographic and dissection studies, and the location and course of the vessels and nerves supplying sartorius are described. A subsequent study was undertaken in two live canines in which the vascular supply to the sartorius was evaluated before and after surgical delay.


RESULTS
The sartorius is supplied by an average of six or seven vascular pedicles, the size, location, and course of which are described. The nerve supply to the sartorius enters at its proximal end and uniformly arises from a branch of the femoral nerve. Variations in branching patterns and course of nerves and vessels are described. Living canine studies demonstrated the dilatation of intramuscular vessels following surgical delay, with the contrast injection of a single remaining vascular pedicle shown to vascularize the entire length of the sartorius muscle.


CONCLUSIONS
The sartorius is highly suitable for local transposition and free muscle transfer for facial reanimation. The neurovascular anatomy is reliable, and the use of surgical delay can augment its vascular supply and increase the arc of rotation for local transposition.
Buckland
Aaron
A
Parkville, Victoria, Australia From the Jack Brockhoff Plastic and Reconstructive Surgery Research Unit, University of Melbourne.
Pan
Wei R
WR
Dhar
Shymal
S
Edwards
Glenn
G
Rozen
Warren M
WM
Ashton
Mark W
MW
Taylor
G Ian
GI
D000818:Animals; D002102:Cadaver; D003287:Contrast Media; D004285:Dogs; D005145:Face / Q000601:surgery*; D005152:Facial Muscles / Q000294:innervation* / Q000601:surgery*; D005154:Facial Nerve / Q000637:transplantation; D005158:Facial Paralysis / Q000601:surgery; D005267:Femoral Nerve / Q000033:anatomy & histology* / Q000098:blood supply* / Q000502:physiology; D006801:Humans; D007002:Hypoglossal Nerve / Q000637:transplantation; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D013997:Time Factors; D014276:Trigeminal Nerve / Q000637:transplantation
D003287:Contrast Media