title: The medial sural artery as recipient vessel and the impact on the medial gastrocnemius.
abstract: Microsurgical free tissue transfer is a valuable technique for the reconstruction of soft-tissue defects around the knee, and the medial sural artery (MSA) is an ideal recipient vessel for anastomosis. Previously, the vessel has been described as the dominant supply to the medial gastrocnemius, but no research has addressed the subsequent effect to the muscle after interruption of MSA. The volume of the postoperative medial gastrocnemius of 4 patients treated with free flap reconstruction using MSA as recipient, was assessed clinically and using magnetic resonance imaging, with muscle function assessed using a patient questionnaire, and measurement of ankle torque with concurrent electromyography. Magnetic resonance imaging volume assessment revealed the postoperative medial head of gastrocnemius proportional to its synergist of separate blood supply, the lateral gastrocnemius and functional assessment suggest little difference between limbs such that the MSA should be used with confidence as recipient vessel for free flap reconstruction of soft-tissue defects around the knee.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia. jdbeumer@gmail.com
authors.forename: Jesse D
authors.initials: JD
authors.lastname: Beumer
authors.forename: Richard
authors.initials: R
authors.lastname: Karoo
authors.forename: Yugesh
authors.initials: Y
authors.lastname: Caplash
authors.forename: John G
authors.initials: JG
authors.lastname: Semmler
authors.forename: Jamie
authors.initials: J
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D001158:Arteries / Q000601:surgery; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D007869:Leg Injuries / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000502:physiology; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D017695:Soft Tissue Injuries / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome