Anatomical study of Vasculature of Gracilis Muscle

Srimuthalage, M (2020) Anatomical study of Vasculature of Gracilis Muscle. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION: Gracilis is the most superficial muscle of the adductor compartment. The word Gracilis is derived from the Latin word Gracile meaning slender. It takes origin by a thin aponeurosis from the medial margin of the pubis, whole of the inferior pubic ramus and the adjoining part of the ischial ramus. Inserted to the upper part of the medial surface of the tibia, just below the medial tibial condyle. The blood supply to Gracilis muscle varies with respect to major and minor vascular pedicles. The major vascular pedicle arises from the artery of the adductors. The Gracilis musculocutaneous flap is based on this pedicle. The blood supply to the skin of the thigh is by musculocutaneous perforators. So a thorough knowledge of vascular pedicles is useful in reconstructive surgeries. AIM AND OBJECTIVE: To study the morphology of Gracilis muscle and its vascular pedicles in detail with a view to the use of muscle flaps in reconstrutive surgeries. MATERIALS AND METHODS: 60 Adult lower limbs of 30 embalmed Human Cadavers from the Institute of Anatomy,Madras Medical College,Chennai are taken for this study. The parameters studied are ◆ Length and Width of Gracilis muscle, ◆ Number of vascular pedicles, ◆ Source of major vascular pedicle, ◆ Length and Diameter of major vascular pedicle, ◆ Entry point of vascular pedicle into the muscle with reference to public tubercle, ◆ Number of minor vascular pedicles, ◆ Length and Diameter of minor vascular pedicle, ◆ Number of musculocutaneous perforators and its distribution in relation to the muscle. RESULTS: ◈ The length of the Gracilis from its origin to insertion including muscle and tendon is 45.23±4.53cm.The length of the Gracilis muscle in males is 50.82±2.73cm and in females 39.64±2.68cm. ◈ The width of the Gracilis is 3.25±0.67cm. The width of the Grailis muscle in males is 3.37±0.64cm and in females 2.66±0.49cm. ◈ The number of vascular pedicles is ranged from one to four.The source of major pedicle is from profunda femoris artery in 73.3% cases and from medial circumflex femoral artery in 26.7% cases. ◈ The length of major pedicle is 4.88±0.98cm and the diameter of major pedicle is 1.51±0.28cm. The length of minor pedicle is 5.13±0.9cm and the diameter of minor pedicle is 1.28±0.15cm. ◈ The entry point of vascular pedicle into the muscle measured with respect to pubic tubercle is 11.17cm for major pedicle, 27.59cm for 1st minor pedicle, 29.84cm for 2nd minor pedicle, 35.25cm for 3rd minor pedicle. ◈ The musculocutaneous perforators are seen in all limbs and their number ranged from one to four, distributed in the upper 1/3rd of the Gracilis muscle. CONCLUSION: Based on this study, I hereby conclude that the anatomy and vasculature of Gracilis muscle has variations in length, width, vascular pedicles in different individuals and in both genders. The length of the Gracilis is useful for Surgeons to decide on the available length for taking a free flap or a pedicled flap in reconstructive surgeries. So, a thorough knowledge on the Gracilis morphology and vascular pattern is required in reconstructive surgeries. Hence this study will be useful to the Surgeons doing reconstructive surgeries.

Item Type: Thesis (Masters)
Additional Information: 201733003
Uncontrolled Keywords: Vascular pedicle, myocutaneous flap, musculocutaneous perforators, free Gracilis flap.
Subjects: MEDICAL > Anatomy
Depositing User: Subramani R
Date Deposited: 06 Feb 2021 02:56
Last Modified: 06 Feb 2021 03:29

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