Research Article| Volume 72, ISSUE 4, P616-621, April 2019

A cadaveric analysis of the blood supply to rectus Femoris

Published:January 07, 2019DOI:



      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.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Standring S.
        Gray's Anatomy.
        Elsevier, 2015
        • Zhao Z.
        • Zhang B.
        • Liu Y.
        • et al.
        Repair of bedsore over greater trochanter in paraplegic patients with rectus femoris island myocutaneous flap.
        Zhonghua Shao Shang Za Zhi Zhonghua Shaoshang Zazhi Chin J Burns. 2014; 30: 227-230
        • Alkon J.D.
        • Smith A.
        • Losee J.E.
        • Illig K.A.
        • Green R.M.
        • Serletti J.M.
        Management of complex groin wounds: preferred use of the rectus femoris muscle flap.
        Plast Reconstr Surg. 2005; 115 (discussion 784-785): 776-783
        • Choa R.
        • Gundle R.
        • Critchley P.
        • Giele H.
        Successful management of recalcitrant infection related to total hip replacement using pedicled rectus femoris or vastus lateralis muscle flaps.
        J Bone Joint Surg Br. 2011; 93: 751-754
        • Sbitany H.
        • Koltz P.F.
        • Girotto J.A.
        • Vega S.J.
        • Langstein H.N.
        Assessment of donor-site morbidity following rectus femoris harvest for infrainguinal reconstruction.
        Plast Reconstr Surg. 2010; 126: 933-940
        • Flurry M.D.
        • Michelotti B.F.
        • Moyer K.E.
        Pedicled rectus femoris flap for coverage of complex open pelvic fractures.
        J Plast Reconstr Aesthetic Surg JPRAS. 2011; 64: 1490-1494
        • Daigeler A.
        • Fansa H.
        • Altmann S.
        • Awiszus F.
        • Schneider W.
        The pedicled rectus femoris muscle flap for reconstruction of complicated abdominal wall defects.
        Rozhl V Chir Mesicnik Ceskoslovenske Chir Spolecnosti. 2005; 84: 238-243
        • Messing E.M.
        • Dibbell D.G.
        • Belzer F.O.
        Bilateral rectus femoris pedicle flaps for detrusor augmentation in the prune belly syndrome.
        J Urol. 1985; 134: 1202-1205
        • Struach B.
        • Yu H.-L.
        Atlas of Microvascular Surgery: Anatomy and Operatvive Techniques.
        THIEME, 2006
        • Struach B.
        • Vasconez L.O.
        • Hall-Findlay E.J.
        • Grabb W.C.
        Grabb's Encyclopedia of Flaps.
        Lippincott-Raven, Philadelphia1998
        • Yang D.
        • Morris S.F.
        Neurovascular anatomy of the rectus femoris muscle related to functioning muscle transfer.
        Plast Reconstr Surg. 1999; 104: 102-106
        • Wong C.-H.
        • Ong Y.S.
        • Wei F.-C.
        Revisiting vascular supply of the rectus femoris and its relevance in the harvest of the anterolateral thigh flap.
        Ann Plast Surg. 2013; 71: 586-590
        • (NCD-RisC)
        N. R. F. C. A century of trends in adult human height.
        eLife. 2016; 5: e13410