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Course of the Femoral Artery in the Mid- and Distal Thigh and Implications for Medial Approaches to the Distal Femur

A CT Angiography Study

Maslow, Jed I. MD; Collinge, Cory A. MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: July 15, 2019 - Volume 27 - Issue 14 - p e659–e663
doi: 10.5435/JAAOS-D-17-00700
Research Article

Introduction: 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.

Methods: 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.

Results: 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.

Discussion: 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.

From the Vanderbilt University Medical Center, Nashville, TN.

Correspondence to Dr. Maslow:

Dr. Collinge or an immediate family member has received IP royalties from Advanced Orthopaedic Solutions, Zimmer Biomet, and Synthes; serves as a paid consultant to Zimmer Biomet and Stryker; and serves as a board member, owner, officer, or committee member of the Foundation of Orthopedic Trauma. Neither Dr. Maslow nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

© 2019 by American Academy of Orthopaedic Surgeons
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