Computed Tomography Angiography-Guided Study of the Superficial Femoral Artery Course in the Thigh and the Identification of Dangerous Zones for Lateral Femoral Surgical Approaches

Background and Objectives: The superficial femoral artery (SFA) can be injured during an intramedullary femoral nailing procedure with proximal and distal cross fixation, performed for proximal femoral fractures and intertrochanteric fractures. The aim of this study was to determine the safe and dangerous zones for the SFA during operative interventions on the femoral body in Turkish society and to define the relationship of these zones with femur length and sex. Materials and Methods: Using a computed tomography angiography, the relationship between the SFA and the medial shaft of the femur was examined in 160 limbs of 80 patients. The upper and lower cut points of the medial part of the SFA in the sagittal plane were defined. The distance of these points to the adductor tubercle was measured and the ratio of this value to the femur length was calculated. Results: The average distance of the SFA to the adductor tubercle in women was 214.2 ± 25.9 mm at the anterior border of the femur, while in men it was 229.8 ± 26.2 mm (p = 0.000). The danger zone length was 85 mm in women and 102 mm in men, and the difference was statistically significant (p = 0.000). The average distance of the SFA to the adductor tubercle at the anterior border of the femur was 223.1 ± 27.3 mm, the average femur length was 374.9 ± 30.2 mm, and a moderate correlation was found between them (r = 0.568). Conclusions: When determining the intraoperative danger zone using anatomical reference points in surgical approaches to the femur, variables such as sex and femur length should not be ignored.