The medial head of the triceps brachii. Anatomy and blood supply of a new muscular free flap: the medial triceps free flap.
OBJECTIVE
The anatomical features of the posterior compartment of the arm seem to provide the basis to raise one of the smallest free muscular flaps, with minimal donor site morbidity: the medial triceps free flap.


METHODS
The anatomic study was carried out on 27 fresh cadaver arms: 7 prepared for corrosion cast, 15 for simple dissection and 5 for dissection after latex injection. Morphological data of the muscle, as well as pedicle constancy and size, were recorded.


RESULTS
The mean size of the medial head was 10.7 × 2.5 × 3.3 cm; the mean weight was 30.1 g. We found a constant and unique pedicle supplying the whole medial head of triceps muscle, composed by the middle collateral artery (MCA), two veins and a nerve. The mean length of MCA was 2.9 cm and the "extended" pedicle, including the deep brachial artery (DBA), was 8-12 cm long. At their origin, the mean caliber of MCA was 1.5 mm and the mean caliber of DBA 2.4 mm.


CONCLUSIONS
Our findings confirmed the reliability of the MC vessels and their anatomical relationships with the medial head of triceps brachii muscle, which could be harvested as a free flap or as a pedicled flap based on anterograde or retrograde flow. This technique should be safe, yielding mild donor site morbidity, and suitable in regional reconstruction or distant reanimations.
Service de Chirurgie Plastique, Reconstructrice, Esthétique et Brulés CHU Pellegrin, Centre François Xavier Michelet, CHU Pellegrin 1, Place Amélie Raba-Léon, 33076, Bordeaux, France.
Gael
G
Piquilloud
Federico
F
Villani
Vincent
V
Casoli
D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D001916:Brachial Artery / Q000033:anatomy & histology; D002102:Cadaver; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology* / Q000098:blood supply / Q000294:innervation