Arterial anatomy of anconeus muscle flap

Anconeus is a small muscle located in the elbow region. The muscle flap may be used as a pedicled flap for the reconstruction of defects of the same area. There are very few studies conducted on the flap anatomy of this muscle. In this study 15 formalin fixed cadavers were dissected under 4x loupe magnification. The arterial blood supply was found to be posterior recurrent interosseous artery. The mean diameter of the artery was 0.5 mm at the origin. The diameter was found to be too small for using the flap as a free flap. The localization of the pedicle was defined according to easy surgical landmarks. The mean distance of the origin from interepicondylar line and from the proximal tip of the olecranon was 73 mm and 28.9 mm respectively. The average length of the pedicle of the flap was found to be 8.5 mm. The localization of the point where the pedicle entered the muscle was calculated according to the distance from the interepicondylar line. The distance of the muscle entry point of the artery to the interepicondylar line was 65.2 mm (range 8-101 mm). It is concluded that although the pedicle is too small to be used as a free flap its constant anatomy makes the flap an ideal muscle flap for the reconstruction of defects of the elbow region. © 2010 OMU All rights reserved

Anatomic Bases of Superficial Temporal Artery and Temporal Branch of Facial Nerve

The superficial temporal artery (STA)-based flaps have been used for different reconstructive purposes. These operations may cause facial nerve injury. The variations of the STA and its relation to temporal branch of the facial nerve (TBFN) were evaluated in this study. Thirteen cadavers with 26 STA and TBFN have been dissected. The bifurcation of STA was found to be 60% above the superior border of the zygomatic arc and 40% below this level. The mean lengths of frontal and temporal branches (FB and TB) of STA were 11.5 and 11.4 cm, respectively. The mean numbers of perforators of FB and TB to deep plane were 1.30 and 1.34, respectively. The mean diameter of STA at the superior border of zygomatic arc was 2.5 mm. The mean diameters of TB and FB at the level of bifurcation were 1.8 mm and 2.0 mm, respectively. The mean number of TBFN at the level of zygomatic arc was 3.70. The mean distance of the first and last branching of TBFN to tragus was found to be 24 mm. The mean number of TBFN at the level of the middle orbita was found to be 2.7. The mean distance of first and last branches of TBFN to the lateral orbital rim was 12 and 24 mm, respectively. The results found in this study may increase the accuracy of flaps based on STA and decrease the risk of facial nerve paralysis during these operations

Anatomy of Vastus Lateralis Muscle Flap

A vastus lateralis muscle flap is used as a pedicled and free flap. In this study, the vastus lateralis muscles of 15 adult formalin-fixed cadavers (30 cases) were dissected. The dominant pedicle was found to be descending branch of the lateral circumflex femoral artery. The mean diameter of the artery was found to be 2.1 mm. This pedicle was located 119.4 mm distal to the pubic symphysis. The mean length of the major pedicle was found to be 56.8 mm when the dominant pedicle was chosen to nourish the flap. The dominant pedicle entered the muscle 155.8 and 213.7 mm from the greater trochanter and the anterior superior iliac spine, respectively. The muscle had proximal minor pedicles from the ascending and transverse branches of lateral circumflex femoral artery. These arteries had mean diameters of 1.8 and 2.0 mm, respectively. The distal minor branches were present in all of the dissections. The distal branch had a mean diameter of 1.8 mm. The origin of this distal branch was located 83.7 mm proximal to the intercondylar line. The motor nerve of the vastus lateralis was found to be originating from femoral nerve. The nerve entered the muscle 194.6 mm from the anterior superior iliac spine

Supraclavicular Artery Flap

Supraclavicular artery-based flaps provide aesthetic and functional coverage for the head and neck region. Fourteen formalin-fixed cadavers were dissected bilaterally, and 28 supraclavicular arteries were evaluated. The origin of the supraclavicular artery was transverse cervical artery in 62.9% and suprascapular artery in 37.1% of the cases. The origin of the artery was at the level of the medial third of the clavicle in 3.7%; 3.7% of the cases were at the junction of medial and middle third of the clavicle, 33.3% at the level of middle third of the clavicle, 11.1% at the junction of middle and lateral thirds, 44.4% at the level of lateral third, and 3.7% at the level of acromioclavicular joint. The mean values of the results were as follows: The diameter of the artery was 1.0 mm at the origin. The distance of the origin of the artery from sternoclavicular joint and from the upper border of the clavicle was 76.4 and 22.2 mm, respectively. The average length of the artery was 70.8 mm. In all dissections, the artery was deep to the platysma muscle. Forty-one percent of supraclavicular arteries accompanied the middle supraclavicular nerve, whereas 59% of the arteries run with lateral supraclavicular nerve. The supraclavicular artery had a parallel course to the 2 horizontal imaginary lines passing from the coracoid process and acromion in 63% of the cases; 18.5% of the arteries were oblique, and 18.5% were vertical to the imaginary lines. The venae comitantes were double in all dissections

Multiple variations in the axillary arterial tree relevant to plastic surgery: A case report

While dissecting the body of a 59 years old male cadaver we observed "abnormal" branching pattern of the axillary artery and unusual vascular pedicles of the serratus anterior muscle. The serratus anterior branch originated directly first part of the axillary artery as the first branch. The lateral thoracic and thoracodorsal arteries arose together from the third part of the axillary artery as "a lateral thoracic-thoracodorsal" common trunk. The superior thoracic artery was out of the position. The circumflex scapular artery originated directly the third part of the axillary artery. The subscapular artery was not present. © 2007 Sociedad Chilena de Anatomía

Anatomy of Gracilis Muscle Flap

Gracilis muscle flap is commonly used in reconstructive surgery. The gracilis muscles of 15 formalin-fixed adult cadavers (30 cases) were dissected with 4 x loupe magnification. The most proximal pedicle of gracilis muscle was the deep branch of the medial circumflex femoral artery. It was located 60 mm from the pubic tubercle and had a diameter of 0.9 m on the average. The second pedicle was the medial circumflex femoral artery. It was the dominant pedicle in 13% of the cases. The mean diameter of the artery was 1.2 mm, and it entered the muscle 98 mm from the pubic tubercle. The third artery that nourished the muscle was deep femoral artery. It was the dominant pedicle in 87% of the cases. It had a mean diameter of 1.6 mm with a length of 54 mm. The most distant pedicles originated from the superficial femoral artery. They were present in all cases and were double in 77% of the cases. Mean diameter and length of the artery were 1.4 and 52 mm, respectively. They entered the muscle 266 mm from the pubic tubercle. These distal pedicles seem to be large enough to elevate the middle part of the muscle as a free flap

Coexistence of Wormian Bones With Metopism, and Vice Versa, in Adult Skulls.

Objective: The aim of the study is to investigate coexistence of Wormian bones with metopism, and vice versa, in adult skulls

Anatomic features of metopic suture in adult dry skulls.

The metopic suture (MS) lies on the midline of the forehead and extends from the frontal bone to the root of the nose. The aim of the current study was to evaluate morphologic features of the complete and incomplete MSs of skulls in the West Anatolian population and rates of the suture types. One hundred sixty crania of West Anatolian people with unknown ages and sex belonging to the anatomy department laboratory of Dokuz Eylul University Medical School were examined. When the MSs that extend from the nasion to the bregma are complete, this condition was named as metopism. The length of the complete sutures was measured using a flexible millimeter calibrated ruler. If the suture was not present throughout between these 2 landmarks (nasion and bregma), these were considered as the incomplete MSs. The incomplete MSs were classified as linear, V-shaped, and double types. The incidence of the complete and incomplete sutures was 75%. The complete (metopism) and incomplete MSs were found in 7.50% and 67.50% of the skulls, respectively. The most common type was linear (39.40%), followed by double shaped (23.10%) and V shaped (5%). The mean length of the complete MS was 12.30 cm. Because the localization and types of MSs are important during clinical approaches, while evaluating patients with head trauma in the emergency department, these should be considered