We have previously shown that the neurovascular anatomy and length
of the
long head of biceps femoris
(LHBF) is suitable for its possible use in the creation of a dynamic perianal
myoplasty to restore faecal
continence. If intramuscular arterioarterial anastomoses exist between
a
muscle's vascular pedicles then the
delay procedure, i.e. ligating the vascular pedicles to the transposed
section of
the muscle, 4–6 wk before
transposition, can be used to improve blood flow to the distal part of
the
transposed muscle. The
intramuscular arterial anatomy of 20 biceps femoris muscles was shown by
dissection (14) or
radiographically (6). The mean entry point of the upper major vascular
pedicle
to the LHBF was 12 cm
(s.d. 3.3) and the mean length of the LHBF was 36.8 cm (s.d. 1.8). Therefore
the
ratio between upper
major vascular pedicle entry point and muscle length in 95% of specimens
was
0.33 (0.2). In the present
study intramuscular arterioarterial anastomoses were found between the
arterial
pedicles to the non-transposed and transposed sections of the LHBF and
between
the long and short heads of this muscle.
Using the delay procedure would therefore theoretically allow the intramuscular
arterioarterial anastomoses
between the arterial pedicle to the nontransposed and transposed sections
of
the LHBF to open up
enhancing blood flow to the distal part of the myoplasty.