Subject(s)
Bosentan/adverse effects , Capillary Leak Syndrome/chemically induced , Scleroderma, Systemic/drug therapy , Bosentan/therapeutic use , Capillary Leak Syndrome/diagnosis , Endothelin Receptor Antagonists/adverse effects , Endothelin Receptor Antagonists/therapeutic use , Humans , Male , Middle Aged , UltrasonographySubject(s)
Granulomatosis with Polyangiitis , Immunoglobulins, Intravenous/administration & dosage , Pyoderma Gangrenosum , Rituximab , Vaginal Diseases , Adult , Anti-Inflammatory Agents/administration & dosage , Antibodies, Antineutrophil Cytoplasmic/immunology , Autoantibodies/blood , Biopsy/methods , Female , Granulomatosis with Polyangiitis/diagnosis , Granulomatosis with Polyangiitis/drug therapy , Granulomatosis with Polyangiitis/immunology , Humans , Immunologic Factors/administration & dosage , Immunologic Factors/adverse effects , Methylprednisolone/administration & dosage , Myeloblastin/immunology , Peritonitis/diagnosis , Peritonitis/etiology , Peritonitis/surgery , Pyoderma Gangrenosum/diagnosis , Pyoderma Gangrenosum/etiology , Pyoderma Gangrenosum/physiopathology , Pyoderma Gangrenosum/therapy , Respiration, Artificial/methods , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/etiology , Respiratory Insufficiency/therapy , Rituximab/administration & dosage , Rituximab/adverse effects , Treatment Outcome , Vaginal Diseases/diagnosis , Vaginal Diseases/etiology , Vaginal Diseases/physiopathology , Vaginal Diseases/therapyABSTRACT
The lateral circumflex femoral artery (LCFA) is responsible for vascularisation of the head and neck of the femur, greater trochanter, vastus lateralis and the knee. The origin of the LCFA has been reported to vary significantly throughout the literature, with numerous branching patterns described and variable distances to the mid-inguinal point reported. The aim of this study was to determine the estimated population prevalence and pooled means of these anatomical characteristics, and review their associated clinical relevance. A search of the major electronic databases was performed to identify all articles reporting data on the origin of the lateral circumflex femoral artery and its distance to the mid-inguinal point. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching, and distance to mid-inguinal point was extracted and pooled into a meta-analysis. A total of 26 articles (n = 3731 lower limbs) were included in the meta-analysis. Lateral circumflex femoral artery most commonly originates from the deep femoral artery with a pooled prevalence of 76.1% (95% confidence interval 69.4-79.3). The deep femoral artery-derived lateral circumflex femoral artery was found to originate with a mean pooled distance of 51.06 mm (95% confidence interval 44.61-57.51 mm) from the mid-inguinal point. Subgroup analysis of both gender and limb side data were consistent with these findings. Due to variability in the lateral circumflex femoral artery's origin and distance to mid-inguinal point, anatomical knowledge is crucial for clinicians to avoid iatrogenic injuries when performing procedures in the femoral region, and thus radiographic assessment prior to surgery is recommended. Lastly, we propose a new classification system for origin of the lateral circumflex femoral artery.
Subject(s)
Femoral Artery/anatomy & histology , Terminology as Topic , Female , Humans , MaleABSTRACT
The superficial fibular (peroneal) nerve (SFN) is one of the successive branches of the common fibular (peroneal) nerve and goes on to bifurcate into the medial dorsal cutaneous (MDN) and intermediate dorsal cutaneous (IDN) nerves. The SFN is a main contributor to sensory innervation of the foot and lower leg. It varies widely in its penetrance of the deep (crural) fascia, and differences in its subsequent course can result in iatrogenic injuries. Articles on the prevalence of this anatomical variation were identified by a comprehensive database search. The data collected were extracted and pooled into a meta-analysis. A total of 14 articles (n = 665 lower limbs) were included on the meta-analysis of SFN variations in fascial piercing. The normal Type 1 variation, where the SFN pierces the deep fascia as a single entity and later bifurcates into the MDN and IDN, had a pooled prevalence of 82.7% (95%CI: 74.0-89.4). The Type 2 variant, where the SFN bifurcates early and then pierces the fascial layer separately as the MDN and IDN, had a pooled prevalence of 15.6% (95%CI: 8.9-23.6). Type 3, when the SFN penetrates the deep fascia and courses similar to the MDN with absent IDN was noted in 1.8% (95%CI: 0.0-4.9) of cases. A substantial portion of the population has a pattern of SFN piercing that deviates from the normal Type 1 anatomy. It is recommended that possible SFN variants in patients should be addressed thoroughly to help prevent iatrogenic injuries and postoperative complications. Clin. Anat. 30:120-125, 2017. © 2016 Wiley Periodicals, Inc.
