Kovalchuk P. Ye., Khmara T. V., Komar T. V., Tulyulyuk S. V.

TOPOGRAPHIC AND ANATOMICAL JUSTIFICATION USING THE TRICEPS SURAE FOR MYOPLASTY OF DEFECTS OF THE TIBIA

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About the author:

Kovalchuk P. Ye., Khmara T. V., Komar T. V., Tulyulyuk S. V.

Heading:

MORPHOLOGY

Type of article:

Scientific article

Annotation:

Myoplasty of tibial defects is of great practical importance for improving regenerative capabilities in the treatment of tibial fractures with significant defects and in osteomyelitis of this segment, especially caused by gunshot wounds. The use of this technique requires an understanding of the topography of the vessels and nerves of the muscles to preserve the functionality of the remaining part of the muscle and the viability of the flap. A detailed knowledge of the anatomy of the nerves inside the muscles is necessary for the successful fabrication of flaps. Intramuscular nerve damage can be as dangerous to the flap as vascular damage. The purpose of this study was to establish the feasibility of using the triceps muscle to fill tibial cavities and soft tissue defects by the muscle plastic method, taking into account the intramuscular distribution of nerves and arteries. The sources of innervation and blood supply of the triceps surae, the number of muscle branches, and the levels of their departure and entry into the heads of the triceps surae were determined by the method of macromicroscopic layer-by-layer preparation of nerves and arteries on preparations of the lower limbs of fetuses of 4-10 months and cadavers of mature people. Special attention is paid to the topographical and anatomical relationship of nerves and arteries when they enter the triceps surae and intramuscular branching in the heads of the gastrocnemius and soleus. It was established that the intramuscular nerve and arterial branches in the lateral and medial heads of the gastrocnemius are located along the muscle bundles and do not go beyond the muscle. The gastrocnemius and soleus are suitable for filling defects on the inner and back surfaces of the upper half of the tibia since their nerves and vessels enter mainly in the upper third of the muscles. Depending on the size of the defect, it is possible to move part of the longitudinally dissected muscle or the entire belly separated from the tendon. The peculiarities of the location of the nerve and arterial branches of the triceps surae in fetuses and adults allow safe movement of the muscle heads during surgical interventions, preserving the integrity of nerves and vessels.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 2, 173, 381-386 pages, index UDC 616.748.54-089.843-031:611.984-032

DOI:

10.29254/2077-4214-2024-2-173-381-386