We have previously shown that the neurovascular anatomy and length of
the long head of biceps femoris (LHBF) is suitable for its possible us
e in the creation of a dynamic perianal myoplasty to restore faecal co
ntinence. If intramuscular arterioarterial anastomoses exist between a
muscle's vascular pedicles then the delay procedure, i.e. ligating th
e vascular pedicles to the transposed section of the muscle, 4-6 wk be
fore transposition, can be used to improve blood flow to the distal pa
rt of the transposed muscle. The intramuscular arterial anatomy of 20
biceps femoris muscles was shown by dissection (14) or radiographicall
y (6). The mean entry point of the upper major vascular pedicle to the
LHBF was 12 cm (S.D. 3.3) and the mean length of the LHBF was 36.8 cm
(S.D. 1.8). Therefore the ratio between upper major vascular pedicle
entry point and muscle length in 95% of specimens was 0.33 (0.2). In t
he present study intramuscular arterioarterial anastomoses were found
between the arterial pedicles to the nontransposed and transposed sect
ions of the LHBF and between the long and short heads of this muscle.
Using the delay procedure would therefore theoretically allow the intr
amuscular arterioarterial anastomoses between the arterial pedicle to
the nontransposed and transposed sections of the LHBF to open up enhan
cing blood flow to the distal part of the myoplasty.