Feb 14, 2024

Public workspaceMorphology of gracilis muscle and the topographic anatomy of its neurovascular pedicles

  • 1Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
Open access
Protocol Citationchettiar ganesh kumar, Murlimanju Virupakshamurthy 2024. Morphology of gracilis muscle and the topographic anatomy of its neurovascular pedicles. protocols.io https://dx.doi.org/10.17504/protocols.io.e6nvwdm6dlmk/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License,  which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: November 06, 2023
Last Modified: February 14, 2024
Protocol Integer ID: 90462
Abstract
Gracilis is often utilized as a graft in the procedures of reconstruction and functioning muscle transfer.1 It is excellent for the closure of recto-vaginal and rectourethral fistulas. The distal pedicle is used during the total knee arthroplasty as a soft tissue graft.2,3 It also has wider application in the management of wounds of the groin, contractures, scars, reanimation of the face,4,5 reconstruction of the mammary gland,6and anterior cruciate ligament reconstruction.7 Additional harvesting of the gracilis has proven to offer better post-operative functional activity like in hamstring injury.8 The main vascular pedicle of gracilis is from the medial and lateral circumflex femoral arteries, which branch from the deep femoral artery, which enters the gracilis at the junction of its upper and middle third. Distal part of the gracilis is supplied by the femoral artery9.
Morphology of gracilis muscle and the topographic anatomy of its neurovascular pedicles
Morphology of gracilis muscle and the topographic anatomy of its neurovascular pedicles
Morphology of gracilis muscle and the topographic anatomy of its neurovascular pedicles
Protocol references
Macchi V, Vigato E, Porzionato A, et al.: The gracilis muscle and its use in clinical reconstruction: an anatomical, embryological, and radiological study. Clin. Anat. 2008;21(7):696-704.
Ulrich D, Roos J, Jakse G, Pallua N: Gracilis muscle interposition for the treatment of recto-urethral and rectovaginal fistulas: a retrospective analysis of 35 cases. J. Plast. Reconstr. Aesthet. Surg.2009;62(3):352-356.
3. Tiengo C, Macchi V, Vigato E, et al.: Reversed gracilis pedicle flap for coverage of a total knee prosthesis. J. Bone Joint Surg. Am. 2010;92(7):1640-1646.
Hussey AJ, Laing AJ, Regan PJ: An anatomical study of the gracilis muscle and its application in groin wounds. Ann. Plast. Surg. 2007;59(4):404-409.
Hassan KM, El-Moghazy AEAM, Mahmoud MA, El-Oteify M: Study of neurovascular anatomy of the split gracilis muscle for the purpose of facial reanimation. Egypt. J. Plast. Reconstr. Surg. 2009;33(2):261-269.
Peek A, Müller M, Ackermann G, Exner K, Baumeister S: The free gracilis perforator flap: anatomical study and clinical refinements of a new perforator flap. Plast. Reconstr. Surg.2009;123(2):578-588.
Candal-Couto JJ, Deehan DJ: The accessory bands of gracilis and semitendinosus: an anatomical study. Knee.2003;10(4):325-328.
Yosmaoglu HB, Baltaci G, Ozer H, Atay A: Effects of additional gracilis tendon harvest on muscle torque, motor coordination, and knee laxity in ACL reconstruction. Knee Surg. Sports Traumatol. Arthrosc.2011;19(8):1287-1292.
Stranding S, Borley NR, Gray H: Gray’s anatomy: the anatomical basis of clinical practice. 41st ed. Edinburgh: Churchill Livingstone/Elsevier; 2016.
Mitsala G, Varey AH, O'Neill JK, Chapman TW, Khan U: The distally pedicled gracilis flap for salvage of complex knee wounds. Injury. 2014;45(11):1776-1781.
Tetreault MW, Della Valle CJ, Hellman MD, Wysocki RW: Medial gastrocnemius flap in the course of treatment for an infection at the site of a total knee arthroplasty. JBJS. Essent. Surg. Tech. 2017;7(2):e14.
Amin K, Dempsey M, Ghali S, Grobbelaar A: Saving grace: distally pedicled gracilis muscular flap in lower limb salvage. BMJ Case Rep. 2014;2014-205486.
Cavadas PC, Sanz-Giménez-Rico JR, Landín L, Martínez-Soriano F: Segmental gracilis free flap based on secondary pedicles: anatomical study and clinical series. Plast. Reconstr. Surg. 2004;114(3):684-691.
Jung JA, Kim YW, Cheon YW: Reverse gracilis muscle flap: an alternative means of skin coverage for recurrent infection after TKA. Knee Surg Sports Traumatol Arthrosc. 2013;21(12):2779-2783.
Rajeshwari MS, Kumar BNR: An anatomical study of gracilis muscle and its vascular pedicles. Int. J. Anat. Res.2015;3(4):1685-1688.
Magden O, Tayfur V, Edizer M, Atabey A: Anatomy of gracilis muscle flap. J. Craniofac. Surg. 2010;21(6):1948-1950.