Abstract
Gastrocnemius muscle forms the belly of the calf. It arises by two heads. Each head is attached to either condyles of the femur by strong flat tendons and to the subjacent part of the capsule of the knee joint. Normally the upper third and part of the middle third is fleshy and then it becomes tendinous, uniting with the tendon of soleus, to form the tendo-achilles. The tendo-achilles is the thickest and strongest tendon in the human body measuring 15cm in length. It begins near the middle of the leg and gets attached to the posterior, mid level of the calcaneum. We are reporting new anatomical variations in this case apart from the previously documented ones. 1. Lateral and medial heads of Gastrocnemius are fleshy in its entire length. 2. Fleshy fibres of the lateral and medial heads are discrete and attach directly to the posterior aspect of the calcaneum. 3. Total absence of the achilles tendon. At the outset these findings have clinical relevance because it has been suggested that the absence of a well developed achilles tendon in the African apes would preclude them from effective running, both at high speeds and over extended distances. Bilateral achilles tendon vibration in the absence of vision has a major impact on postural orientation. Secondly the routine procedure of flap cover for the middle third soft tissue defects of the leg is the usage of soleus muscle flap. To add to the armamentarium of flap cover for middle third defects of the leg, gastrocnemius muscle flap is used as it was found to be fleshy throughout.
Highlights
Gastrocnemius and soleus muscles make up the three headed triceps surae
Total absence of the achilles tendon. At the outset these findings have clinical relevance because it has been suggested that the absence of a well developed achilles tendon in the African apes would preclude them from effective running
The routine procedure of flap cover for the middle third soft tissue defects of the leg is the usage of soleus muscle flap
Summary
Gastrocnemius and soleus muscles make up the three headed triceps surae. The large size of these two muscles is a human characteristic related to upright stance and bipedal locomotion. The Achilles is the tendinous expansion of two muscles gastrocnemius and soleus It is the thickest and strongest tendon in the body. The calcaneal tendon spirals 90° during its descent so that the gastrocnemius fibers attach laterally and the soleus fibers medially. This arrangement is thought to be significant to the tendons elastic ability to absorb shock and recoil. On the operating table the necrosed portion of the skin over the lateral aspect of the left leg was excised and the cleavage between the gastrocnemius and soleus was obtained. The medial head of the gastrocnemius was cut at its insertion, tunneled and covered over the fracture segments and skin grafted. The medial head of the gastrocnemius was cut at its insertion, tunneled and covered over the fracture segments and skin grafted. (Figure 3 and Figure 4)
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