The medial head of the triceps brachii. Anatomy and blood supply of a new muscular free flap: the medial triceps free flap.

PURPOSE: The anatomical features of the posterior compartment of the arm seem to provide the basis to raise one of the smallest free muscular flaps, with minimal donor site morbidity: the medial triceps free flap.

METHODS

The anatomic study was carried out on 27 fresh cadaver arms: 7 prepared for corrosion cast, 15 for simple dissection and 5 for dissection after latex injection. Morphological data of the muscle, as well as pedicle constancy and size, were recorded.

RESULTS

The mean size of the medial head was 10.7 × 2.5 × 3.3 cm; the mean weight was 30.1 g. We found a constant and unique pedicle supplying the whole medial head of triceps muscle, composed by the middle collateral artery (MCA), two veins and a nerve. The mean length of MCA was 2.9 cm and the "extended" pedicle, including the deep brachial artery (DBA), was 8-12 cm long. At their origin, the mean caliber of MCA was 1.5 mm and the mean caliber of DBA 2.4 mm.

CONCLUSIONS

Our findings confirmed the reliability of the MC vessels and their anatomical relationships with the medial head of triceps brachii muscle, which could be harvested as a free flap or as a pedicled flap based on anterograde or retrograde flow. This technique should be safe, yielding mild donor site morbidity, and suitable in regional reconstruction or distant reanimations.