Mathes and Nahai classification of muscle circulation

Mathes and Nahai classification of muscle circulation and list examples of muscles used for free transfers from each group

  • • Type I: One vascular pedicle
  • • Type II: One dominant pedicle and minor pedicles
  • • Type III: Two dominant pedicles
  • • Type IV: Segmental vascular pedicles
  • • Type V: One dominant and secondary vascular pedicles
  • Type I
    • • Tensor fascia latae is perfused solely by the transverse branch of the lateral femoral circumflex artery.
    • • The extensor digitorum brevis is perfused by a branch of the dorsalis pedis artery.
  • Type II
    • • The gracilis muscle is perfused by a major pedicle that is a terminal branch of the medial femoral circumflex artery. One to two minor pedicles from the superficial femoral artery enter the muscle distally.
    • • The soleus muscle is perfused by branches directly from the popliteal vessels. The distal 4 to 5 cm of muscle is perfused by segmental perforating vessels from the posterior tibial artery.
  • Type III
    • • The rectus abdominis is perfused by two dominant pedicles, the superior arising from the superior epigastric artery and the inferior arising from the deep inferior epigastric artery.
    • • The serratus anterior is perfused by the lateral thoracic artery superiorly and the thoracodorsal artery inferiorly.
  • Type IV
    • • No type IV muscles are appropriate for free transfers.
  • Type V
    • • The latissimus dorsi is perfused predominantly by the thoracodorsal artery. The muscle also receives a segmental blood supply medially by branches of the intercostal and lumbar arteries.
    • • The pectoralis major receives its major blood supply from the thoracoacromial artery. It is also perfused by the lateral thoracic artery, the internal mammary artery, and the intercostal artery.
    • • The pectoralis minor is predominantly perfused by the lateral thoracic artery. A direct branch of the axillary artery and the pectoral branch of the thoracoacromial artery provide secondary vascularization.

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