Blood Supply of the Medial Head of Gastrocnemius
The medial head of the gastrocnemius muscle receives its dominant blood supply from the medial sural artery, which arises from the popliteal artery approximately 1.2 cm above the knee joint. 1
Primary Vascular Anatomy
The medial sural artery represents the principal arterial supply with the following characteristics:
- Origin: Arises from the popliteal artery 1.2 cm proximal to the femorotibial articulation 1
- Diameter: Approximately 1.9 mm at its origin 1
- Course: Travels approximately 3 cm distally before penetrating the muscle belly 1
- Pedicle length: Averages 2.1-2.3 cm, which is relatively short and allows for high division of the muscle when used as a flap 2
Intramuscular Distribution Pattern
Once the medial sural artery enters the muscle, it demonstrates a consistent branching pattern:
- Primary branches: Divides into 2-3 main branches within the muscle substance 1
- Bifurcation pattern: The medial sural artery consistently shows distal bifurcation in 100% of cases, making the segmental vascular anatomy highly predictable 2
- Musculocutaneous perforators: Secondary branches provide arterial supply to the overlying dorsomedial leg skin 1
Vascular Pattern Classification
The blood supply follows a Type 1 pattern in 85% of cases, characterized by:
- Single dominant pedicle: One medial sural artery supplies the entire medial gastrocnemius head 3
- Type 2 variant: In 15% of cases, two sural arteries may supply the medial head 3
- Dominant intramuscular vessel: A single vessel typically dominates the intramuscular distribution 3
Clinical Relevance
The consistent segmental vascular pattern of the medial gastrocnemius makes it highly reliable for surgical flap procedures:
- The medial head can be safely divided into segments due to its predictable bifurcating arterial supply 2
- The muscle serves as an excellent donor site for both pedicled and free tissue transfer 3
- The short pedicle length permits proximal muscle division while maintaining viability 2