Anatomy of the medial femoral circumflex artery and its surgical implications.

Détails

ID Serval
serval:BIB_41D7827B4924
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Anatomy of the medial femoral circumflex artery and its surgical implications.
Périodique
Journal of Bone and Joint Surgery. British Volume
Auteur⸱e⸱s
Gautier E., Ganz K., Krügel N., Gill T., Ganz R.
ISSN
0301-620X (Print)
ISSN-L
0301-620X
Statut éditorial
Publié
Date de publication
2000
Volume
82
Numéro
5
Pages
679-683
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
The primary source for the blood supply of the head of the femur is the deep branch of the medial femoral circumflex artery (MFCA). In posterior approaches to the hip and pelvis the short external rotators are often divided. This can damage the deep branch and interfere with perfusion of the head. We describe the anatomy of the MFCA and its branches based on dissections of 24 cadaver hips after injection of neoprene-latex into the femoral or internal iliac arteries. The course of the deep branch of the MFCA was constant in its extracapsular segment. In all cases there was a trochanteric branch at the proximal border of quadratus femoris spreading on to the lateral aspect of the greater trochanter. This branch marks the level of the tendon of obturator externus, which is crossed posteriorly by the deep branch of the MFCA. As the deep branch travels superiorly, it crosses anterior to the conjoint tendon of gemellus inferior, obturator internus and gemellus superior. It then perforates the joint capsule at the level of gemellus superior. In its intracapsular segment it runs along the posterosuperior aspect of the neck of the femur dividing into two to four subsynovial retinacular vessels. We demonstrated that obturator externus protected the deep branch of the MFCA from being disrupted or stretched during dislocation of the hip in any direction after serial release of all other soft-tissue attachments of the proximal femur, including a complete circumferential capsulotomy. Precise knowledge of the extracapsular anatomy of the MFCA and its surrounding structures will help to avoid iatrogenic avascular necrosis of the head of the femur in reconstructive surgery of the hip and fixation of acetabular fractures through the posterior approach.
Mots-clé
Aged, Aged, 80 and over, Arthroplasty, Replacement, Hip/adverse effects, Female, Femoral Artery/anatomy & histology, Femoral Artery/surgery, Femur Head Necrosis/prevention & control, Femur Neck/blood supply, Hip/blood supply, Humans, Male, Middle Aged, Muscle, Skeletal/blood supply
Pubmed
Web of science
Création de la notice
26/11/2012 20:19
Dernière modification de la notice
20/08/2019 14:42
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