Neurovascular Anatomy

The arterial supply is from the medial femoral circumflex artery (a branch of the profunda femoris artery). The artery courses between the adductor longus and adductor brevis muscles to reach the middle third of the gracilis muscle. The diameter of the artery is between 1 and 2 mm and the diameter of the accompanying vena comitantes

Figure 34 Typical configuration for a free gracilis muscle flap to correct facial palsy. The muscle is anchored along the zygoma and sutured into the modiolus. A cross-facial nerve graft was previously placed and anastomosed with the anterior branch of the obturator nerve.

is between 1 and 1.5 mm. Multiple musculocutaneous perforators supply the overlying skin. No sensory component is described. The motor nerve is derived from the anterior branch of the obturator nerve (Fig. 35). The obturator nerve splits into a posterior branch that passes under the adductor brevis muscle and an anterior branch that passes superficial to this muscle on its way to the gracilis muscle. Prior to entering the muscle, the anterior branch of the obturator nerve divides into several branches that innervate distinct longitudinal segments of gracilis muscle.

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