title: Position of the superficial femoral artery in closed hip nailing.
abstract: BACKGROUND
  Adduction of the ipsilateral hip joint is necessary to facilitate closed hip nailing for trochanteric fracture. Even though positioning the patient supine with the perineal post against the ipsilateral medial thigh can change the course of the neurovascular structure in the proximal thigh, there have been no reports regarding the position of the femoral artery in the hip nailing position.
  
  
  METHODS
  We studied the position of the superficial femoral artery in 59 thighs using color-flow duplex scanning method in three hip nailing positions.
  
  
  RESULTS
  The mean of the distance between the superficial femoral artery and the femur in 48 normal limbs was 20.28 mm in neutral position (D1), 11.85 mm in 20(o) adduction (D2), and 9.53 mm in 20(o) adduction plus 20(o) internal rotation of the foot plate (D3). The distances D2 and D3 were always shorter than D1 ( p<0.001). D3 was less than 10 mm in 30 of the normal limbs (62.5%) and less than 5 mm in 4 (8%). In 11 patients who sustained a trochanteric fracture, the mean of D1, D2, and D3 in the injured limbs was 25.28 mm, 17.98 mm, and 14.38 mm, respectively. The mid-thigh circumference and D3 of the injured limbs were always greater than those of the normal limbs ( p<0.001). However, D3 of both sides was less than 10 mm in 3 patients.
  
  
  CONCLUSIONS
  To lessen the vascular injury during hip nailing, we recommend that the limb be placed in neutral position during preparation of the interlocking holes.
authors.affiliation: Department of Orthopaedic Surgery, Youngdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dokokdong Kangnamgu, Seoul, Korea. kyang@yumc.yonsei.ac.kr
authors.forename: Kyu Hyun
authors.initials: KH
authors.lastname: Yang
authors.forename: Choon Sik
authors.initials: CS
authors.lastname: Yoon
authors.forename: Hui Wan
authors.initials: HW
authors.lastname: Park
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Won
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D005263:Femoral Artery / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005593:Fracture Fixation, Internal / Q000379:methods*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011187:Posture; D018615:Ultrasonography, Doppler, Color