- Anatomy:
- origin:
- originates from pubic tubercle & inferior ramus of pubis;
- anterior aspect of lower 1/2 of symphysis pubis and medial of inferior ramus of pubic arch;
- insertion: pes arserinus
- action:
- adduction of thigh at the hip; flexion of the leg at the knee;
- medially rotates the femur and tibia;
- reversed origin insertion action: when the leg is fixed, the gracilis flexes the pelvis at hip;
- synergists: adductor brevis, adductor longus, adductor magnus, pectineus;
- nerve supply: obturator, L2, L3, L4; (see innervation of the lower extremity)
- Gracilis Muscle Flap:
- viability of muscle based on distal blood supply, which is branch of saphenous artery, is less likely beyond its distal third;
- muscle has three to five vascular pedicles supply it along its length;
- largest and most important of these is the proximal one, which is branch of the profunda femoris;
- other vascular pedicles travel along intermuscular septi & are smaller;
- entire muscle can survive on its proximal pedicle, which is largest;
- skin island is totally unreliable in its distal 1/3
Late reconstruction of the patellar tendon.
Reversed Gracilis Pedicle Flap for Coverage of a Total Knee Prosthesis