Department of Orthopedics, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan.
Department of Radiology, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan.
Medicina (Kaunas). 2020 Nov 28;56(12):655. doi: 10.3390/medicina56120655.
: The proximity of the popliteal vessels in the distal femur may increase the risk of iatrogenic vascular injury during cerclage wiring. In this study, the closest location and distance of the popliteal vessels to the femur was examined using magnetic resonance imaging (MRI). The associations between anthropometric factors and the distance that would guide the placement of wires safely during surgery were also identified. : We reviewed adult knee magnetic resonance images and recorded: (1) the relation and the shortest horizontal distance (d-H) from the femoral cortex to the popliteal vessels in axial images and (2) the vertical distance (d-V) from the adductor tubercle to the axial level of the d-H values in coronal images. The effects of anthropometric factors (sex, age, body height, body weight, body mass index, thigh circumference, femoral length and femoral width) on these distances were analysed. Analysis of 206 knee magnetic resonance images revealed that the closet locations of popliteal vessels were at the posteromedial aspect of the femur. The d-H and d-V were 7.38 ± 3.22 mm and 57.01 ± 11.14 mm, respectively, and were both shorter in women than in men ( < 0.001). Multivariate analysis identified thigh circumference and femoral length as the most influential factors for the d-H and d-V, respectively ( < 0.001). Linear regression demonstrated a strong positive linear correlation between the thigh circumference and the d-H and between the femoral length and the d-V (Pearson's r = 0.891 and 0.806, respectively ( < 0.001)). The closet location and distance of the popliteal vessels to the femur provide useful information for wire placement during distal femoral fracture surgery while minimising the risk of vascular injury. Given that patients with a smaller thigh circumference and a shorter femoral length are more likely to have a smaller d-H and a shorter d-V, respectively, cautious measures should be taken in such cases.
: 腘血管在股骨远端的毗邻关系可能会增加在使用钢丝环扎固定时发生医源性血管损伤的风险。在这项研究中，我们使用磁共振成像（MRI）检查了腘血管与股骨的最近位置和距离。还确定了与距离相关的人体测量学因素，这些因素可以指导手术中钢丝的安全放置。 : 我们回顾了成人膝关节 MRI 图像，并记录了：（1）在轴位图像中，股骨皮质与腘血管的关系和最短水平距离（d-H）；（2）在冠状图像中，从收肌结节到 d-H 值的轴向水平的垂直距离（d-V）。分析了人体测量学因素（性别、年龄、身高、体重、体重指数、大腿周径、股骨长度和股骨宽度）对这些距离的影响。 对 206 例膝关节 MRI 图像的分析表明，腘血管最靠近的位置在股骨的后内侧。d-H 和 d-V 分别为 7.38 ± 3.22mm 和 57.01 ± 11.14mm，女性均短于男性（ < 0.001）。多元分析确定大腿周径和股骨长度分别为 d-H 和 d-V 的最具影响力的因素（ < 0.001）。线性回归显示，大腿周径与 d-H 之间以及股骨长度与 d-V 之间存在很强的正线性相关性（Pearson r = 0.891 和 0.806，分别（ < 0.001））。 腘血管与股骨的最近位置和距离为股骨远端骨折手术中钢丝放置提供了有用的信息，同时最大限度地降低了血管损伤的风险。鉴于大腿周径较小和股骨长度较短的患者分别更有可能具有较小的 d-H 和较短的 d-V，因此在这种情况下应采取谨慎措施。
