From the Vanderbilt University Medical Center, Nashville, TN.
J Am Acad Orthop Surg. 2019 Jul 15;27(14):e659-e663. doi: 10.5435/JAAOS-D-17-00700.
Unfamiliarity with the location of the femoral artery in the medial thigh has tempered surgeons' enthusiasm for medial approaches to the distal femur. The purpose of this study was to define the relationship of the femoral artery to the mid- and distal femur to assist in safely approaching the femur for fracture care.
Fifteen patients undergoing CT with angiography (CTA) of the lower extremity (CTA) were evaluated. From three-dimensional CTA images, the distance of the artery at the anterior border, midsagittal line, and posterior border of the femur from the distal femur at both the adductor tubercle and medial femoral condyle was measured.
The average distances of the adductor tubercle to the femoral artery were 23.2 cm (±3.3), 18.8 cm (±3.4), and 14.3 cm (±4.1) at the level of the anterior border, midsagittal line, and posterior border of the femur, respectively. The descending genicular artery (DGA) originated 10.8 cm (±1.3) proximal to the adductor tubercle.
A wide safe zone exists in the medial distal femur. The artery crosses the midsagittal axis of the medial femur an average of 18.8 cm proximal to the adductor tubercle.
由于对股动脉在大腿内侧的位置不熟悉，外科医生对股骨远端的内侧入路的热情有所降低。本研究的目的是确定股动脉与股骨中、远端的关系，以协助安全地接近股骨进行骨折治疗。
对 15 例行下肢 CT 血管造影（CTA）的患者进行评估。从三维 CTA 图像中，测量了股动脉在股骨前、中、后缘至收肌结节和股骨内髁远端的距离。
在股骨前、中、后缘，收肌结节至股动脉的平均距离分别为 23.2cm（±3.3）、18.8cm（±3.4）和 14.3cm（±4.1）。膝降动脉（DGA）起源于收肌结节近端 10.8cm（±1.3）处。
在股骨远端的内侧存在一个宽阔的安全区域。动脉在收肌结节近端平均 18.8cm 处跨越股骨内侧的正中轴。
