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Farouk Osama M.D.; Krettek, Christian M.D.; Schandelmaier, Peter M.D.; Said, Galal Z. M.D.; Tscherne, Harald M.D.
Techniques in Orthopaedics: September 1999
Minimally Invasive Orthopaedics: Article: PDF Only


A cadaver arterial injection study was performed to analyze the vascular supply to the femur and to study the effects of two surgical plating techniques on femoral vascularity. Long plates of three different types were applied on proximal, distal, and midshaft of intact femora of 20 fresh human cadavers. On one side, the plate was inserted using a conventional lateral approach, with elevation of the vastus lateralis muscle to expose the shaft. On the contralateral side, the plate was inserted percutaneously beneath the muscle using a minimally invasive technique. After plating, blue silicone dye was injected through the common femoral artery. Cadaver dissection then was performed to identify the femoral perforating arteries and the nutrient artery of the femur. The distance of each was measured from the greater trochanter. The pattern of periosteal filling of the injected dye was analyzed and the topography of perforators was determined. The percutaneous plate insertion maintained the integrity of the vascular supply and showed a better periosteal perfusion pattern than the conventional technique. The results of this study indicate that the minimal invasive plating technique is superior to the conventional one in maintaining femoral vascularity and perfusion.

© 1999 Lippincott Williams & Wilkins, Inc.