Maximizing the Reach of the Pedicled Gastrocnemius Muscle Flap: A Comparison of 2 Surgical Approaches

Background: The medial gastrocnemius muscle flap is commonly used for the reconstruction of defects around the knee and proximal leg. The flap can be raised using either a medial or a posterior midline incision, although no studies have been done comparing the 2 different surgical approaches. Methods: We compared the reach of the medial gastrocnemius muscle flap using either of the 2 incisions in a series of 25 fresh cadavers. All muscle flaps were elevated without division of the muscle origin. Muscle reach was calculated using the distance from a fixed bony point with the leg fully extended and the muscle under no tension. Muscle width measurements were used to calculate surface area of coverage. Results: Muscle flaps elevated through the posterior midline incision group reached 2.02 cm farther than flaps through the medial incision (P

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