Anatomical Variations of ProfundaFemoris Artery in Indian Population

Background: Aim: To assess anatomical variations of profundafemoris artery in Indian population.Methods:45 embalmed lower extremities adult human cadavers age range of 30–65 years were recruited for the study. The femoral triangles were dissected with proper care to identify the profundafemoris and circumflex femoral arteries. Their source of origin, position, and distance were noted with the mid-inguinal point (MIP) as a reference point.Results:Side of profundafemoris artery (PFA) was postero- lateral in 60%, posterior in 30%, lateral in 5% and absent in 5%. Medial circumflex femoral artery (MCFA) had 65%, 15%, 12% and 8% and lateral circumflex femoral artery (LCFA) had 80%, 15%, 5% and 0% respectively. Origin of profundafemoris artery (PFA) was FA in 90% and common trunk with medial circumflex femoral artery in 10%. Origin of Medial circumflex femoral artery (MCFA) was FA in 55%, PFA in 40% and FA with common trunk with MCFA in 5%. Origin of lateral circumflex femoral artery (LCFA) was femoral artery in 70%, PFA in 20% and FA with common trunk with PFA in 10%. A significant difference was observed (P< 0.05).Conclusions:A thorough knowledge of variation of profunda femoral artery is of great importance and to avoid complications.

In vivo experimental study of the arterial supply of the rabbit posterior limb

Background: The use of bone graft has been a successful step in the treatment of a large number of diseases of the osteoarticular system. But a massive bone defect remains a dilemma for modern reconstructive surgery. Present methods used have a high level of morbidity and complication. Literature indicates the absence of an optimal solution in massive bone defects healing. The aim of this study: to perform an in vivo preliminary study of vascularization of the hind limb in the rabbit model, for obtaining a graft able for further inclusion in the host blood circulation, without immunosuppression by decellularization. Material and methods: The study was performed on the 12 laboratory rabbits. After euthanasia of the rabbit, the femoral and tibiofibular bone was collected without soft tissue, only with the vascular pedicle, and keeping the passage through the vessels. In the abdominal aorta was injected contrast material, with the subsequent preparation of the arterial vessels, succeeded by anatomical, morphological, radiography, and microangiography study of this vascularized bone segment. Results: The principal nutrient artery of the rabbit femur springs from the lateral circumflex femoral artery. The optimal segment for vascularized allografting (the rabbit model) was determined the upper third of the femur with the up to the level of the internal iliac artery. So, it could be used as a bone graft for further conservation and decellularization. Conclusions: The vascularized allogeneic bone without immunosuppression would be a perfect alternative in the treatment of the massive bone defects.

Reconstruction of Complex Soft-Tissue Defects in Buttock Using The Proximally Based Anterolateral Thigh Flap: An Alternative Algorithm

Background Local and free flaps are most widely used in buttock reconstruction. However, local flaps and free flaps may not be appropriate for all complex soft tissue defects in buttock. In this study, we propose an alternative approach for buttock reconstruction and provide preliminary assessment in clinical efficacy of using a proximally based anterolateral thigh flap for buttock reconstruction. Methods In this study, we retrospectively analyzed the data of the patients with medium- to large-sized defects of buttock. All patients underwent buttock defect reconstruction using a proximally based anterolateral thigh flap between August 2012 and December 2020. Results Eight pedicled anterolateral thigh flaps were used to reconstruct buttock defects after tumor ablation in six patients, scar revision in one patient, melanocytic nevus resection in one patient. Flap size ranged from 25 × 8 cm to 30 × 12 cm, with pedicle length ranging from 12 to 20 cm. Flaps were elevated based on the distal musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery and completely survived without any perfusion-related complications. We achieved satisfactory results from both the functional and aesthetic point-of-view at the 6-month follow-up in all cases. Conclusions The proximally based anterolateral thigh flap can be a valuable reconstructive option with sufficient tissue and a long vascular pedicle for buttock defect reconstruction.

Prevalence of the additional head of quadriceps femoris in the South Indian population: a cadaveric and radiological study

Quadriceps femoris is an extensor muscle in the anterior compartment of thigh and is traditionally taught to be composed of four heads. Recently, there is an increased interest in the occurrence of an additional muscle head of quadriceps femoris. But scientific knowledge regarding its incidence is lacking in the South Indian population. This study was done to confirm the presence of the additional head by routine anatomic dissection and radiological imaging techniques. Forty-one formalin fixed human cadaveric lower limbs were dissected and the morphology of the additional head was noted. Retrospective analysis of 88 MRI images of patients was done. The additional muscle head was present in 43.9% of the cadaveric lower limbs and was consistently located between the vastus lateralis and vastus intermedius. It originated from variable portions of the greater trochanter, intertrochanteric line, lateral lip of linea aspera and lateral surface of the shaft of femur and inserted either as a muscle belly or as an aponeurosis into the vastus intermedius (55.6%), vastus lateralis (22.2%) or directly into the base of the patella. It received its vascular supply from branches of the lateral circumflex femoral artery and was innervated by branches from the posterior division of the femoral nerve. In addition, the additional muscle head was identified by MRI and its incidence was reported to be 30.68% for the first time in living subjects. The result of this study provides additional information in understanding the morphology of the quadriceps femoris muscle.

Variations in the Circumflex Branches of the Profunda Femoris Artery - A Cadaveric Study

BACKGROUND The external iliac artery passes behind the inguinal ligament into the front of the thigh as the femoral artery (FA). The FA gives off many branches both superficial and deep. The profunda femoris artery (PFA) is one of the deep branches given off in the femoral triangle in front of the thigh. The PFA gives off the medial circumflex femoral artery (MCFA) and the lateral circumflex femoral arteries (LCFA) and continues downwards giving off the first, second and third perforating arteries. The PFA terminates as the fourth perforating artery. Many variations in the circumflex branches of the PFA have been found by various authors. These variations are of great significance during procedures done in front part of the thigh. METHODS This is a descriptive cadaveric study. We dissected the thighs of 57 embalmed bodies. We looked for the medial (MCFA) and lateral (LCFA) circumflex arteries which are branches of PFA. Each artery was followed till its termination. The distance of their origin from the point of the origin of PFA from the FA was measured and noted. The distance between pubic symphysis and anterior superior iliac spine was measured using black silk and measuring scale. The midpoint was marked using skin marking pen and an incision extending from anterior superior iliac spine to pubic symphysis was made. Another incision was made from the above midpoint to the midpoint of a horizontal incision at the level of knee joint. Femoral sheath was identified and incised. Femoral artery, profunda femoris artery and its circumflex branches were identified. The modes of origin of MCFA and LCFA were noted. The distance of origin of these from the origin of PFA were measured. Variations in the branching pattern of MCFA and LCFA were looked for and noted down. RESULTS We found that in 83 % of the total cases MCFA took origin from PFA and its origin was from the FA in 13 %. In 84 % of total cases LCFA arose from PFA on the right side and 70 % on the left side. A common stump of origin was noted in 3 cases. CONCLUSIONS Medial and lateral circumflex branches of PFA exhibit wide variations. KEY WORDS Medial Circumflex Femoral Artery, Lateral Circumflex Femoral Artery, Variations in Origin and Branching