Morphological variants of nerve to gastrocnemius muscle, an anatomical guide to perform surgical dissection

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Muscles, Ligaments and Tendons Journal


Background. The precise knowledge about distribution of nerves supplying the gastrocnemius muscle is clinically important. The present study aimed to observe the morphological variations in the nerve supply of gastrocnemius in a sample South Indian population. Methods. The study included 38 formalin fixed adult cadaveric lower limbs. Variation in the number and branching pattern of the nerve to gastrocnemius muscle was studied. An imaginary line connecting the medial and lateral epicondyles of the femur, was considered as the reference line to study the topographical origin of the nerves. Results. It was observed that tibial nerve was giving one, two or three branches to the medial head of gastrocnemius muscle in 47.4%, 44.7% and 7.9% cases, respectively. The lateral head of gastrocnemius was receiving single, double or triple branch from tibia nerve in 60.5%, 34.2% and 5% cases, respectively. The nerve that innervated lateral head of gastrocnemius was also supplying soleus in 81.6% cases. The nerve to medial head was found at a higher level than the nerve to lateral head in 27 (71.1%) cases, whereas in 11 (28.9%) cases both were originating at the same level. In 76.3% cases, the nerve to MG was originating above the reference line and in 23.7% cases, below it. The nerve to LG was diverged below the reference line in 84.2% cases, at the reference line in 7.9% cases and above it in 7.9% cases. Conclusion. We report variations in the number and topography of nerves supplying the gastrocnemius muscle, that are enlightening to the operating plastic surgeon during the procedures like triceps surae nerve block and calf reduction. This data can be used as an anatomical guide to perform the surgical dissection.

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