Arterial supply of the gracilis muscle and its relevance for the dynamic graciloplasty

The various methods of transposition of the gracilis muscle in order to ser ve as an anal neo-sphincter have progressed in recent years. Tetanic contra ction can be achieved by converting Type II muscle fibers into Type I by us e of chronic, low frequency electrical stimulation. In order to guarantee a good function the muscle's vascularization has to have at least one nutrit ive vessel. In our investigation we worked out the various forms of the muscle's arteri al blood supply. Dissecting 66 specimens we detected four with only one nut ritive vessel, 23 with a double-supply and, as the most common constellatio n, in 34 cases three supplying arteries. A small group of five individuals showed more than three arterial vessels. Because of the fact that the obturator nerve is not running with the incomi ng arteries, an angle was measured between the length axis of the muscle an d the first perforating artery. This information should help the surgeon to preserve the nerve. Clin. Anat. 12:159-163, 1999. (C) 1999 Wiley-Liss,Inc.