Mathes and Nahai classification of muscle flaps

mathes and nahai classification of muscle flaps

Type I

• Single vascular pedicle.

• Examples:

  1. Gastrocnemius
  2. Tensor fasciae latae (TFL)
  3. Abductor digiti minimi.

Type II

  • Dominant pedicle(s) and other minor pedicle(s).
  • These flaps can be based on the dominant pedicle after the minor pedicle(s)
    are ligated.
  •  Circulation via minor pedicles alone is not reliable, so this type of flap is usually based on dominant pedicle, with or without inclusion of minor pedicles.
  • When gracilis muscle which is usually used as a free flap, minor pedicles are ligated and the flap is entirely supplied by the dominant pedicle.
  • Examples:
  1. Trapezius
  2. Soleus
  3. Gracilis.

Type III

  •  Two dominant pedicles, each arising from a separate regional artery or opposite sides of
    the muscle.
  • Useful muscles for transfer because flaps can be based on either pedicle.

• Examples:

  1. Rectus abdominis
  2. Pectoralis minor
  3. Gluteus maximus.

Type IV

• Multiple segmental pedicles.

• Examples: sartorius, tibialis anterior, long flexors and extensors of the toes.

• Seldom used for transfer because each pedicle supplies only a small portion of muscle.

Type V

  •  One dominant pedicle and secondary segmental pedicles.
  • Flaps can be based on either the dominant pedicle or secondary segmental pedicles

• Examples:

  1. Latissimus dorsi
  2. Pectoralis major.

 

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