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Surgical anatomy of the lateral circumflex femoral artery branches: Contribution to the blood loss control during hip arthroplasty.
Annals of Anatomy ( IF 2.2 ) Pub Date : 2020-06-27 , DOI: 10.1016/j.aanat.2020.151566
T Totlis 1 , G Paparoidamis 2 , I Terzidis 1 , M Piagkou 3 , E Tsiridis 4 , K Natsis 5
Affiliation  

Background

The lateral circumflex femoral artery (LCFA) branches encountered during anterior and lateral hip approaches; although vessels’ haemostasis is suggested in surgical textbooks, literature is scarce regarding their topography. The current study defines the exact location of the LCFA and its branches, based on osseous landmarks, as well as their size and possible variants, providing helpful information for intraoperative identification and demonstrating the magnitude of potential haemorrhage during hip surgery.

Methods

Twenty-three human cadavers (46 lower limbs) were dissected. The LCFA branching pattern was recorded. The distances of the LCFA origin and its first branch from the anterior superior iliac spine (ASIS) were measured. Length and width of the LFCA, LCFA ascending and transverse branches (LCFAab and LCFAtb) were calculated and compared to the ipsilateral ulnar artery (UA) width, which was served as a comparative guide.

Results

The LFCA origin was located 106.9 ± 17.5 mm distal and 65.6 ± 14.7 mm medial to the ASIS, while the LFCA first branch origin was 115.1 ± 24.3 mm distal and 48.2 ± 14.3 mm medial to the ASIS. The mean lengths of the LCFA, LCFAab and LCFAtb were 23.2 ± 12.6 mm, 44.8 ± 14.9 mm and 42.3 ± 13.6 mm, respectively. Their mean widths were 4.3 ± 1.0 mm, 2.9 ± 0.9 mm and 2.7 ± 0.7 mm, respectively, while the mean UA width was 2.7 ± 0.4 mm.

Conclusion

The surgeon may detect the LCFA and its branching, at a mean distance of 110 mm (range 100−126 mm), distal to the ASIS. The LCFAab and LCFAtb widths are similar to the UA width. Meticulous knowledge of the branching pattern topography and vessels’ size may contribute to a successful management of the intraoperative blood loss.



中文翻译:

外侧旋支股动脉分支的手术解剖:髋关节置换术期间失血控制的贡献。

背景

髋外侧入路和前外侧入路遇到的外侧旋支股动脉(LCFA);尽管在外科教科书中建议血管止血,但是关于血管地形的文献很少。当前的研究基于骨标志物及其大小和可能的变体,定义了LCFA及其分支的确切位置,为术中识别和显示髋关节手术中潜在出血的幅度提供了有用的信息。

方法

解剖了23具人体尸体(46下肢)。记录LCFA分支模式。测量了LCFA起源及其第一分支与前上棘(ASIS)的距离。计算LFCA,LCFA上升和横向分支(LCFAab和LCFAtb)的长度和宽度,并将其与同侧尺动脉(UA)宽度进行比较,以作为比较指南。

结果

LFCA起源位于ASIS远端106.9±17.5 mm和内侧65.6±14.7 mm,而LFCA第一分支起源位于ASIS远端115.1±24.3 mm和48.2±14.3 mm。LCFA,LCFAab和LCFAtb的平均长度分别为23.2±12.6 mm,44.8±14.9 mm和42.3±13.6 mm。它们的平均宽度分别为4.3±1.0 mm,2.9±0.9 mm和2.7±0.7 mm,而UA的平均宽度为2.7±0.4 mm。

结论

外科医生可以在距ASIS远端110毫米(100-126毫米)的平均距离处检测LCFA及其分支。LCFAab和LCFAtb的宽度类似于UA的宽度。对分支模式的地形和血管大小的细致了解可能有助于成功处理术中失血。

更新日期:2020-07-06
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