The first perforating branch of the deep femoral artery: A reliable recipient vessel for vascularized fibular grafts: An anatomical study

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• 作者：Yoo Joon Sur^a ; ^b ; Mohamed Morsy^a ; ^c ; Anita T. Mohan^a ; ^d ; Lin Zhu^a ; ^e ; Nirusha Lachman^f ; Michel Saint-Cyr^a ; ^{msaint-cyr@sw.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Osteonecrosis of the femoral head ; Vascularized fibular graft ; Deep femoral artery ; Perforating branch ; Anatomical study
• 刊名：Journal of Plastic, Reconstructive & Aesthetic Surgery
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：69
• 期：3
• 页码：351-358
• 全文大小：1470 K

文摘

Although the perforating branches of the deep femoral artery have been introduced as recipient vessels for vascularized fibular grafts in the treatment of osteonecrosis of the femoral head, comprehensive knowledge of the related anatomy is deficient. The aims of this study were to provide detailed anatomical data for the perforating branches of the deep femoral artery and validate their usefulness as recipient vessels for vascularized fibular grafts.

Materials and methods

Anatomical dissection was performed on 11 fresh human cadaveric lower extremities. The number, locations, and diameters of the perforating branches were documented. The topographic relationships with the vastus ridge and the tendinous insertion of the gluteus maximus were clarified. The diameters of the perforating branches were compared with those of the ascending branch of the lateral circumflex femoral and the peroneal arteries.

Results

The mean number of perforating branches was 3.5. The mean distances from the vastus ridge to the first, second, and third perforating branches were 8.1, 13.7, and 20.4 cm, respectively. The first perforating branch was always located medial to the tendinous insertion of the gluteus maximus, whereas the second perforating branch was always located distal to the gluteus maximus. The mean diameters of the first, second, third, and fourth perforating branches were 3.1, 2.3, 1.6, and 1.2 mm, respectively. The mean diameters of the ascending branch of the lateral circumflex femoral and the peroneal arteries were 2.0 and 3.6 mm, respectively.

Conclusion

The first perforating branch of the deep femoral artery is an appropriate alternative recipient vessel for vascularized fibular grafts in the treatment of osteonecrosis of the femoral head. It has a very consistent anatomy with a suitable location and diameter for anastomosis of the peroneal artery.