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.
From the *Department of Plastic and Reconstructive Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia; †Discipline of Physiology, School of Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; and ‡Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Received August 27, 2010, and accepted for publication, after revision, December 2, 2010.
Conflicts of interest and sources of funding: none declared.
Reprints: Jesse D. Beumer, MBBS, Department of Plastic and Reconstructive Surgery, North Wing Link Level 5 Royal Adelaide Hospital, North Terrace Adelaide, South Australia 5000, Australia. E-mail: email@example.com.