Division of Clinical and Functional Anatomy, Department of Anatomy, Histology, and Embryology, Innsbruck Medical University, Innsbruck, Austria.
J Vasc Surg. 2010 Apr;51(4):982-9. doi: 10.1016/j.jvs.2009.08.094.
Varicose veins are a frequent burden, also in the small saphenous system. Yet its basic anatomy is not described consistently. We therefore investigated the fascial and neural relationships of the small saphenous vein (SSV) as well as the frequency and position of valves and the different junctional patterns, also considering the thigh extension.
We dissected the legs of 51 cadavers during the regular dissection course held in winter 2007 at Innsbruck Medical University, with a total of 86 SSVs investigable proximally and 94 SSVs distally.
A distinct saphenous fascia is present in 93 of 94 cases. It starts with a mean distance of 5.1 cm (SD 1.2 cm) proximal to the calcaneal tuber, where the tributaries to the SSV join to form a common trunk. The neural topography at the level of the gastrocnemius muscle's origins shows the medial sural cutaneous nerve in 88% medially and in 12% laterally to the SSV, the tibial nerve in 64% medially and in 36% laterally, and the common fibular nerve in 98% medially and in 2% laterally to the vein. The saphenopopliteal junction (SPJ) resembled in about 37% type A (UIP-classification), 15% type B, and 24% type C. A total of 17% of specimens showed a venous web or star at the popliteal fossa and 6% had a doubled junction. A thigh extension could be demonstrated in about 84%. A most proximal valve was present in only 94% at a mean distance of 1.2 cm (SD 1.4 cm) to the SSVs orifice. A consecutive distal valve was only present in 65% with a mean distance of 5.1 cm (SD 2.3 cm).
Two fascial points or regions can be described in the SSVs' course and its own saphenous fascia is demonstrated macroscopically in almost all cases. The neural topography is highly individual. The SPJ is highly individual where we found hitherto unclassified patterns in a remarkable number of veins. Venous valves are not as frequent as we supposed them to be. Furthermore, not all most proximal valves seem to be terminal valves.
静脉曲张是一种常见的负担，也存在于小隐静脉系统中。然而，其基本解剖结构并未得到一致描述。因此，我们研究了小隐静脉（SSV）的筋膜和神经关系，以及瓣膜的频率和位置以及不同的连接模式，同时也考虑了大腿伸展。
我们在 2007 年冬季因斯布鲁克医科大学常规解剖课程中解剖了 51 具尸体的腿部，总共可在近端检查 86 条 SSV，在远端检查 94 条 SSV。
在 94 例中有 93 例存在明显的隐静脉筋膜。它始于跟骨结节近端平均 5.1 厘米（SD 1.2 厘米）处，在此处 SSV 的分支汇合成一条共同的干。腓肠肌起点处的神经解剖显示，内侧腓肠神经 88%位于 SSV 内侧，12%位于 SSV 外侧，胫神经 64%位于 SSV 内侧，36%位于 SSV 外侧，腓总神经 98%位于 SSV 内侧，2%位于 SSV 外侧。隐-膕静脉连接（SPJ）类似于约 37%的 A 型（UIP 分类），15%的 B 型和 24%的 C 型。约 17%的标本在腘窝处显示静脉网或星状结构，6%的标本显示双连接。大约 84%的标本可以进行大腿伸展。最靠近的瓣膜仅存在于 94%的标本中，距离 SSV 口平均 1.2 厘米（SD 1.4 厘米）。连续的远端瓣膜仅存在于 65%的标本中，平均距离为 5.1 厘米（SD 2.3 厘米）。
可以在 SSV 的行程中描述两个筋膜点或区域，并且在几乎所有情况下都可以在宏观上显示其自身的隐静脉筋膜。神经解剖是高度个体化的。SPJ 高度个体化，我们在大量静脉中发现了迄今为止未分类的模式。静脉瓣膜并不像我们想象的那样常见。此外，并非所有最靠近的瓣膜似乎都是终端瓣膜。
