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Review Question - QID 12

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QID 12 (Type "12" in App Search)
A 32-year-old male sustains a type IIIb open proximal third tibia fracture. Four days after intramedullary nailing of the tibia, the wound is clean and ready for coverage with a medial gastrocnemius rotational flap. What is the dominant arterial blood supply to this flap?

Superior and inferior genicular arteries

4%

131/3065

Anterior tibial artery

2%

46/3065

Posterior tibal artery

25%

772/3065

Sural artery

59%

1808/3065

Saphenous artery

9%

291/3065

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The dominant arterial blood supply to a medial gastrocnemius muscle flap is the sural artery.

Rotational gastrocnemius flaps are useful for coverage of the proximal third of the tibia and some wounds/defects about the knee. Medial and lateral gastrocnemius arterial supply is from the medial and lateral sural arteries respectively. Coverage of the middle third of the tibia requires use of a rotational soleus muscle flap, supplied by the peroneal artery proximally and the posterior tibial artery distally. Coverage of the distal third of the tibia requires a free muscle flap transfer, based on a specific vascular pedicle.

Illustration A depicts the medial gastrocnemius flap with its sural artery pedicle.

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