Add like
Add dislike
Add to saved papers

Clinical Implications of Fat Grafting in the Posterior Calf: A Dynamic Cadaver-based Study.

BACKGROUND: Intramuscular fat grafting in extremity muscles, especially the gastrocnemius, has become increasingly popular. However, while safety in truncal muscle fat grafting has been well-studied, research on extremity muscles is lacking.

OBJECTIVES: This study aims to explore the anatomy of the gastrocnemius muscle and adjacent structures concerning intramuscular and subcutaneous recipient sites. Additionally, it seeks to analyze pressure/volume relationships and fat migration patterns during posterior calf grafting.

METHODS: Eight cadaveric lower extremities were examined. A prosection was performed to better understand the vascular complex as it exists about the gastrocnemius. Ultrasound-guided fat injections were then performed into both the subcutaneous and intramuscular layers; dynamic pressures were measured with a manometer. Lastly, dyed-injectate was injected subcutaneously to better elucidate subcutaneous anatomy.

RESULTS: Anatomic prosection demonstrated the proximity of the gastrocnemius muscle to the popliteal venous system which arborized (>1mm) intramuscularly. In the three specimens that underwent intramuscular fat grafting, the peak intramuscular pressures plateaued at 21mmHg (19.5-23mmHg); there was no observed extra-fascial migration of the injectate. With subcutaneous injectate into one specimen, pressures in the subcutaneous space increased (125mmHg) with additional injectate (240cc) while pressures in the intramuscular space remained relatively constant (4mmHg).

CONCLUSIONS: Intramuscular gastrocnemius fat grafting should be done with caution: its proximity to critical veins and sustained increased intramuscular pressures following grafting increases risk of embolus and thrombosis, respectively. Subcutaneous injection may be safer in that increased pressures are not communicated to deep structures. Lastly, we present a novel description of posterior calf subcutaneous compartments that may better allow surgeons to direct and predict subcutaneous injectate.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

Related Resources

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app