Summary
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
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
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
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.
Keywords
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References
- Gray's Anatomy.Elsevier, 2015
- 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
- Management of complex groin wounds: preferred use of the rectus femoris muscle flap.Plast Reconstr Surg. 2005; 115 (discussion 784-785): 776-783
- 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
- Assessment of donor-site morbidity following rectus femoris harvest for infrainguinal reconstruction.Plast Reconstr Surg. 2010; 126: 933-940
- Pedicled rectus femoris flap for coverage of complex open pelvic fractures.J Plast Reconstr Aesthetic Surg JPRAS. 2011; 64: 1490-1494
- The pedicled rectus femoris muscle flap for reconstruction of complicated abdominal wall defects.Rozhl V Chir Mesicnik Ceskoslovenske Chir Spolecnosti. 2005; 84: 238-243
- Bilateral rectus femoris pedicle flaps for detrusor augmentation in the prune belly syndrome.J Urol. 1985; 134: 1202-1205
- Atlas of Microvascular Surgery: Anatomy and Operatvive Techniques.THIEME, 2006
- Grabb's Encyclopedia of Flaps.Lippincott-Raven, Philadelphia1998
- Neurovascular anatomy of the rectus femoris muscle related to functioning muscle transfer.Plast Reconstr Surg. 1999; 104: 102-106
- 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
- N. R. F. C. A century of trends in adult human height.eLife. 2016; 5: e13410
Article info
Publication history
Published online: January 07, 2019
Accepted:
December 21,
2018
Received in revised form:
December 15,
2018
Received:
September 14,
2018
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.