Objective: The present study was undertaken to know the anatomical basis of medial sural artery (MSA) and its perforators in Nepalese.
Methods: The popliteal arteries of 16 preserved cadaveric lower limbs were injected with a mixture of red ink and glycerine. The number, location, diameter of perforators; length and intramuscular course of pedicle; the branching pattern of MSA were observed and measured.
Results: The mean of 2.2 ± 1.2 perforators (range 0-4) was observed. The perforators were clustered between 8.6 and 25.7 cm from the popliteal crease and 0.3-7.5 cm from posterior midline of leg. The dominant perforators were observed in middle 1/3rd of the leg. The average pedicle length was 12.04 ± 3.27 cm. The intramuscular courses of pedicles were observed in deep and superficial strata in 65.7 and 34.3%, respectively. The MSA originated from popliteal artery in 62.5% and common sural artery in 37.5%. An accessory MSA was found in 12.5%. Type I and Type III branching patterns of MSA were observed in 31.2% each whereas Type II was found in 37.5%. The mean external diameter of perforators and MSA were 0.85 ± 0.27 mm and 2.2 ± 0.43 mm, respectively.
Conclusions: The metrical presentation of this study provides an easy access to know about the distribution of perforators and branching pattern of MSA which will help the surgeons to make a convenient plan to harvest the MSA perforator flap in Nepalese population.
Keywords: Cadaver; Flap; Intramuscular; Leg; Medial sural artery perforator.