The posterior intermuscular approach to the vessels of the leg

The posterior intermuscular approach emphasizes preservation of the soleus muscle by an intermuscular surgical approach to the vessels of the leg. The dissection proceeds from a normal zone proximally toward the zone of injury and facilitates selection of the site of microanastomosis. The neurovascular supply of the soleus is guarded, and its numerous venous channels are avoided. The indications and surgical planning are discussed. Two illustrative cases are presented.