A cadaveric analysis of the blood supply to rectus Femoris.


Journal

Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239

Informations de publication

Date de publication:
Apr 2019
Historique:
received: 14 09 2018
revised: 15 12 2018
accepted: 21 12 2018
pubmed: 20 1 2019
medline: 26 12 2019
entrez: 20 1 2019
Statut: ppublish

Résumé

Rectus femoris is a versatile muscle frequently used as a pedicled flap in reconstructive surgery. The anatomy and blood supply of rectus femoris needs to be clearly understood in order to safely preserve its reconstructive and functional capabilities. Classical anatomical description states that the proximal pedicle insertion into rectus femoris is 10- 15 cm from the anterior superior iliac spine (ASIS). The aim of this study was to dissect and identify the pedicular blood supply to rectus femoris and further map its morphology relative to the ASIS. A dissection of 20 embalmed thighs from 10 cadavers was conducted. The distance of arterial insertions into rectus femoris from the ASIS were recorded. The cohort was 60% male of median age 79 with statistical significance defined as p < 0.05. 5%, 50%, and 45% of muscles demonstrated 1, 2, and 3 pedicles respectively. The mean distance from the ASIS to insertion of these pedicles was: proximal 13 cm (SD 2.6), middle 15 cm (SD 2.8), and distal 18 cm (SD 4.1). When grouped by number of pedicles, there was no difference in the mean height of proximal insertion. However, there was significant difference in mean intramuscular proximal-distal difference. These results were replicated when data were expressed as % of cadaver height. This study confirms the pedicular supply of rectus femoris but in contrast to classical literature demonstrates a greater range of pedicle insertions heights. We believe these observations should be considered when safely harvesting the pedicled rectus femoris flap.

Sections du résumé

BACKGROUND BACKGROUND
Rectus femoris is a versatile muscle frequently used as a pedicled flap in reconstructive surgery. The anatomy and blood supply of rectus femoris needs to be clearly understood in order to safely preserve its reconstructive and functional capabilities. Classical anatomical description states that the proximal pedicle insertion into rectus femoris is 10- 15 cm from the anterior superior iliac spine (ASIS). The aim of this study was to dissect and identify the pedicular blood supply to rectus femoris and further map its morphology relative to the ASIS.
METHODS METHODS
A dissection of 20 embalmed thighs from 10 cadavers was conducted. The distance of arterial insertions into rectus femoris from the ASIS were recorded. The cohort was 60% male of median age 79 with statistical significance defined as p < 0.05.
RESULTS RESULTS
5%, 50%, and 45% of muscles demonstrated 1, 2, and 3 pedicles respectively. The mean distance from the ASIS to insertion of these pedicles was: proximal 13 cm (SD 2.6), middle 15 cm (SD 2.8), and distal 18 cm (SD 4.1). When grouped by number of pedicles, there was no difference in the mean height of proximal insertion. However, there was significant difference in mean intramuscular proximal-distal difference. These results were replicated when data were expressed as % of cadaver height.
CONCLUSIONS CONCLUSIONS
This study confirms the pedicular supply of rectus femoris but in contrast to classical literature demonstrates a greater range of pedicle insertions heights. We believe these observations should be considered when safely harvesting the pedicled rectus femoris flap.

Identifiants

pubmed: 30658952
pii: S1748-6815(19)30011-7
doi: 10.1016/j.bjps.2018.12.045
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

616-621

Informations de copyright

Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.

Auteurs

M Williams (M)

Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom. Electronic address: matthew.williams@stcatz.ox.ac.uk.

J Caterson (J)

Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom.

L Cogswell (L)

Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom.

C L M H Gibbons (CLMH)

Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom.

T Cosker (T)

Department of Physiology, Anatomy, and Genetics, Sherrington Rd, Oxford OX1 3PT, United Kingdom.

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