The gracilis is the most medial and superficial of the adductors, running as a long thin muscle from the pubis to the tibia. It is the premier free muscle transfer donor for smile reanimation and multiple reconstructive procedures.
| Origin | Body of the pubis and inferior pubic ramus |
|---|---|
| Insertion | Superomedial tibia — pes anserinus, deep to sartorius |
| Nerve Supply | Anterior division of obturator nerve (L2, L3) |
| Blood Supply | Medial circumflex femoral artery |
| Actions | Adducts the thigh; Flexes the knee; Medially rotates the tibia when the knee is flexed |
|---|
Gracilis free muscle transfer is used for smile reanimation in facial paralysis (anastomosed to the masseteric nerve), tongue reconstruction after glossectomy, forearm reconstruction in severe Volkmann's contracture, and foot reconstruction. Its harvest causes no clinically significant adduction weakness. With semitendinosus, it forms the hamstring ACL graft.
Palpated as the most medial thigh cord during resisted hip adduction.
Gracilis free muscle transfer to the face for dynamic smile reanimation in facial paralysis, with the motor nerve anastomosed to the masseteric nerve to provide reliable motor input.
