Surgical anatomy of the lateral circumflex femoral artery branches: Contribution to the blood loss control during hip arthroplasty.


Journal

Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft
ISSN: 1618-0402
Titre abrégé: Ann Anat
Pays: Germany
ID NLM: 100963897

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 27 03 2020
revised: 11 06 2020
accepted: 13 06 2020
pubmed: 1 7 2020
medline: 28 7 2021
entrez: 1 7 2020
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 32603828
pii: S0940-9602(20)30110-2
doi: 10.1016/j.aanat.2020.151566
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

151566

Informations de copyright

Copyright © 2020 Elsevier GmbH. All rights reserved.

Auteurs

T Totlis (T)

Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; TheMIS Orthopaedic Center, St. Luke's Hospital, Thessaloniki, Greece. Electronic address: totlis@auth.gr.

G Paparoidamis (G)

Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; Academic Orthopaedic Department, "Papageorgiou" General Hospital, Aristotle University Medical School Faculty of Health Sciences, and CORE Lab, CIRI-AUTh, Thessaloniki, Greece.

I Terzidis (I)

Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; TheMIS Orthopaedic Center, St. Luke's Hospital, Thessaloniki, Greece.

M Piagkou (M)

Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece.

E Tsiridis (E)

Academic Orthopaedic Department, "Papageorgiou" General Hospital, Aristotle University Medical School Faculty of Health Sciences, and CORE Lab, CIRI-AUTh, Thessaloniki, Greece; ICAROS International Center for Arthroplasty & Robotic Orthopaedic Surgery, European Interbalkan Medical Center, Thessaloniki, Greece.

K Natsis (K)

Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece; European Interbalkan Medical Center, Thessaloniki, Greece.

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