True Anterior Hip Approach by Anatomical dissection

Abstract

"Purpose: To evaluate safe triangle within femoral triangle for the potential space of true anterior hip approach

Material and Methods: Cadaveric dissections were done on 51 femoral triangles of 26 cadevers. We measured length of the direct head of rectus femoris from anterior superior iliac spine (ASIS) to patella upper pole, ASIS to lateral border of femoral nerve, and entry point of femoral nerve and vessel branches to rectus. We analyzed the safe portion within the risky femoral triangle and applied it to two clinical situations, femoral head fracture and septic hip arthritis.

Result: Usually, there were three terminal branches to rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal 17.5 ？ 31.4% portion of the rectus femoris. The second and the third branch entered at the proximal 22.5 ？ 40.7% and 26.3 ？ 42.3%, respectively. The vessel entry was at 20.2 ？ 37.3%. The length from ASIS to femoral nerve was 3.5 ？ 8.5cm. Using this space, the operation was done much easier in the two situations mentioned above.

Conclusion: We suggest that the space within femoral triangle between proximal 17.5% of rectus femoris and iliacus could be used as one of the potential space for femoral head fracture fixation, septic hip irrigation in children and arthroscopy portal

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