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计算机断层扫描血管造影引导下对股浅动脉在大腿走行的研究及股外侧手术入路危险区域的识别

Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches.

作者信息

Mertsoy Yılmaz, Kavak Şeyhmus, Şenol Ayhan

机构信息

Department of Orthopedics and Traumatology, UHS Gazi Yaşargil Training and Research Hospital, Diyarbakır 21600, Türkiye.

Department of Radiology, UHS Gazi Yaşargil Training and Research Hospital, Diyarbakır 21600, Türkiye.

出版信息

Medicina (Kaunas). 2025 Feb 28;61(3):441. doi: 10.3390/medicina61030441.

DOI:10.3390/medicina61030441
PMID:40142252
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11944110/
Abstract

: The superficial femoral artery (SFA) can be injured during an intramedullary femoral nailing procedure with proximal and distal cross fixation, performed for proximal femoral fractures and intertrochanteric fractures. The aim of this study was to determine the safe and dangerous zones for the SFA during operative interventions on the femoral body in Turkish society and to define the relationship of these zones with femur length and sex. : Using a computed tomography angiography, the relationship between the SFA and the medial shaft of the femur was examined in 160 limbs of 80 patients. The upper and lower cut points of the medial part of the SFA in the sagittal plane were defined. The distance of these points to the adductor tubercle was measured and the ratio of this value to the femur length was calculated. : The average distance of the SFA to the adductor tubercle in women was 214.2 ± 25.9 mm at the anterior border of the femur, while in men it was 229.8 ± 26.2 mm ( = 0.000). The danger zone length was 85 mm in women and 102 mm in men, and the difference was statistically significant ( = 0.000). The average distance of the SFA to the adductor tubercle at the anterior border of the femur was 223.1 ± 27.3 mm, the average femur length was 374.9 ± 30.2 mm, and a moderate correlation was found between them ( = 0.568). : When determining the intraoperative danger zone using anatomical reference points in surgical approaches to the femur, variables such as sex and femur length should not be ignored.

摘要

在对股骨近端骨折和股骨转子间骨折进行近端和远端交叉固定的髓内股骨钉固定手术过程中,股浅动脉(SFA)可能会受到损伤。本研究的目的是确定在土耳其人群中对股骨体进行手术干预时SFA的安全区和危险区,并明确这些区域与股骨长度和性别的关系。:使用计算机断层血管造影术,对80例患者的160条肢体中SFA与股骨干内侧的关系进行了检查。定义了SFA矢状面内侧部分的上下切点。测量这些点到内收肌结节的距离,并计算该值与股骨长度的比值。:女性股骨前缘处SFA到内收肌结节的平均距离为214.2±25.9mm,男性为229.8±26.2mm(P = 0.000)。女性的危险区长85mm,男性为102mm,差异具有统计学意义(P = 0.000)。股骨前缘处SFA到内收肌结节的平均距离为223.1±27.3mm,股骨平均长度为374.9±30.2mm,两者之间存在中度相关性(P = 0.568)。:在股骨手术入路中使用解剖学参考点确定术中危险区时,不应忽视性别和股骨长度等变量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/183f3faf8a78/medicina-61-00441-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/d95816dd318e/medicina-61-00441-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/f7b1bfec266b/medicina-61-00441-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/183f3faf8a78/medicina-61-00441-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/d95816dd318e/medicina-61-00441-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/eaa7b42ca3b5/medicina-61-00441-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/1194e832be84/medicina-61-00441-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/7402d648b91f/medicina-61-00441-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/f7b1bfec266b/medicina-61-00441-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8cb/11944110/183f3faf8a78/medicina-61-00441-g007.jpg

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本文引用的文献

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Safe Zones and Trajectory of Femoral Pin Placement in Robotic Total Knee Arthroplasty.机器人全膝关节置换术中股骨针置入的安全区域与轨迹
Arthroplast Today. 2023 Sep 19;23:101186. doi: 10.1016/j.artd.2023.101186. eCollection 2023 Oct.
2
Navigation of femoral and popliteal artery around the knee with CT angiography: implications for surgical interventions.利用CT血管造影术对膝关节周围股动脉和腘动脉的走行进行研究:对手术干预的意义
Surg Radiol Anat. 2023 Nov;45(11):1515-1523. doi: 10.1007/s00276-023-03241-5. Epub 2023 Sep 21.
3
Safe and dangerous zones for the superficial femoral artery in femoral surgery.
Acta Orthop Belg. 2022 Sep;88(3):441-446. doi: 10.52628/88.3.9623.
4
Evaluation of the positional relationship between femoral arteries and distal screws in the proximal femoral intramedullary nail for preventing iatrogenic vascular injury.评估股骨近端髓内钉中股动脉与远端螺钉的位置关系,以预防医源性血管损伤。
Injury. 2020 Feb;51(2):384-388. doi: 10.1016/j.injury.2019.10.003. Epub 2019 Oct 3.
5
Identification of the medial femoral safe zone for drilling during dynamic hip screw side plate fixation: A CT angiogram tracing of the profunda femoris artery.经股深动脉 CT 血管造影追踪定位动力髋螺钉侧板固定术中股骨内侧安全钻孔区。
Injury. 2019 Mar;50(3):720-726. doi: 10.1016/j.injury.2019.01.010. Epub 2019 Jan 15.
6
Course of the Femoral Artery in the Mid- and Distal Thigh and Implications for Medial Approaches to the Distal Femur: A CT Angiography Study.股动脉在大腿中、下段的走行及其对股骨远端内侧入路的影响:CT 血管造影研究。
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7
Safe zones and a technical guide for cerclage wiring of the femur: a computed topographic angiogram (CTA) study.股骨环扎术的安全区域及技术指南:计算机断层血管造影(CTA)研究
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8
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Radiological assessment of the safe zone for medial minimally invasive plate osteosynthesis in the distal femur with computed tomography angiography.应用计算机断层血管造影术对股骨远端内侧微创钢板接骨术安全区域的影像学评估
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