The gastrocnemius with soleus bi-muscle flap Ikuo Hyodo, Bin Nakayama, Mitsuru Takahashi, Kazuhiro Toriyama, Yuzuru Kamei, Shuhei Torii  British Journal of Plastic Surgery  Volume 57, Issue 1, Pages 77-82 (January 2004) DOI: 10.1016/j.bjps.2003.10.008

Figure 1 The positions of the perforators penetrating the lateral and medial heads of the gastrocnemius muscle from the soleus muscle were measured as a ratio using the distance between the fibula head and the perforating points and the distance between fibula head and lateral malleolus, and the ratio using the distance between the center of gastrocnemius muscles and the perforating points and the distance between the center of gastrocnemius muscles and lateral border of muscles. All perforators were marked on 16 cadavers. There was a high frequency of perforators on the margin. In all cases perforators was found distal half of the gastrocnemius muscle. British Journal of Plastic Surgery 2004 57, 77-82DOI: (10.1016/j.bjps.2003.10.008)

Figure 2 (A) Perforators penetrating from soleus muscle to the lateral and medical heads gastrocnemius muscle. The gastrocnemius muscle was excluded and the soleus muscle remained. (B) Perforator penetrating from the soleus muscle to the gastrocnemius muscle. British Journal of Plastic Surgery 2004 57, 77-82DOI: (10.1016/j.bjps.2003.10.008)

Figure 3 Angiography done in a fresh cadaver via the lateral sural artery after the soleus and gastrocnemius muscles were raised, confirmed that reversed flow could be seen from the external margin of the lateral head of the soleus muscle (underlined). British Journal of Plastic Surgery 2004 57, 77-82DOI: (10.1016/j.bjps.2003.10.008)

Figure 4 (A,B) Harvesting the gastrocnemius muscle (G) include soleus muscle (S). British Journal of Plastic Surgery 2004 57, 77-82DOI: (10.1016/j.bjps.2003.10.008)

Figure 5 (A,B) Preoperative view. At the upper third of the tibia heat-treated bone was exposed. British Journal of Plastic Surgery 2004 57, 77-82DOI: (10.1016/j.bjps.2003.10.008)

Figure 6 Postoperative view, 2 years after surgery. British Journal of Plastic Surgery 2004 57, 77-82DOI: (10.1016/j.bjps.2003.10.008)