Perforating arteries of the thigh: An anatomical and radiological study

Abstract

As in other parts of the body, textbook descriptions of anatomical structures may not be reflected consistently in vivo. However, the perforating branches of the profunda femoris demonstrate a predictable topographical relationship to palpable bony landmarks.

There are no safe areas for avoiding the perforating arteries along the proximal part of the femur: A word of caution

“…Farouk et al () reported a constant number of four perforating arteries in all of the 40 legs they investigated. Our data show that their number can vary between two and seven, which was also discussed by Dissanayake et al (). On the other hand, Lipshutz () reported the possibility of two to five and Adachi () of only two to four perforating arteries.…”

“…Although some authors tried to fix the origin of the perforating arteries (Siddharth et al, ; Dissanayake et al, ), or their passage near the body of the femur (Farouk et al, ), the present investigation showed that the position of the individual perforating arteries is quite variable. It was not possible to identify hotspots of these arteries, neither for their origin nor for their passage.…”

“…It was not possible to identify hotspots of these arteries, neither for their origin nor for their passage. Calculating mean values of the level of origin or passage of the individual arteries to describe their real position as done by former authors (Siddharth et al, ; Farouk et al, ; Dissanayake et al, ) has turned out impossible for our results. The source and course of the individual arteries are also dependent on the total number of perforating arteries and their respective number of branches in each individual leg of the same subject.…”

“…In living persons, it may be difficult to determine accurately the midpoint of the inguinal ligament (Siddharth et al, ) or the tip of the greater trochanter (Farouk et al, ), especially during surgical interventions. Two imaginary lines (Dissanayake et al, ) connecting bony landmarks that are partly difficult to palpate also do not seem to be particularly useful during clinical practice. Therefore, we used a line between two landmarks that are always palpable, even if the leg is covered by a blanket in the operating theater.…”

“…Only few authors have attempted to identify the exact position of the perforating arteries along the body of the femur. These studies differ methodologically, especially concerning the reference landmarks used (Siddharth et al, ; Farouk et al, ; Dissanayake et al, ). Almost all authors measured the level of origin of the perforating arteries from the deep artery of thigh.…”