Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip

Méndez Aguirre, Omar y Morales Avalos, Rodolfo y Compeán Martínez, Gustavo A y Espinosa Uribe, Abraham G. y Vílchez Cavazos, José Félix y Theriot Girón, María del Carmen y Quiroga Garza, Alejandro y De la Garza Castro, Oscar y Guzmán Avilán, Katia Denisse y Guzmán López, Santos y Elizondo Omaña, Rodrigo Enrique (2016) Neurovascular Structures at Risk During Anterolateral and Medial Arthroscopic Approaches of the Hip. International Journal of Morphology, 34 (2). pp. 752-758. ISSN 0717-9502

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Resumen

To describe the safety areas for placement of 5 anterolateral portals (anterior, anterior lateral, posterior lateral, proximal anterior medial and distal anterior medial portals) and 3 recently described medial portals (anterior medial, posterior medial and distal posterior medial portals) to provide topographical description of the safety of each. A descriptive, observational and crosssectional study in which femoral triangle dissection was performed in 12 hips. 5 lateral portals and the 3 medial portals were placed. Clinically relevant neurovascular structures associated with each portal, were identified measured and documented. The lateral portal with the highest risk of injury to a nearby neurovascular structure was the anterior portal, the most adjacent to the femoral cutaneous nerve, 1.42 cm (±0.85) lateral to the portal. In the medial portals, the anterior medial portal has the narrowest margin in relation to the femoral artery, 2.14 cm (±0.35) lateral to the portal and medial to the obturator nerve by 0.87 cm (±0.62). The lateral portals have a higher safety margin; the portal with the most proximity to a neurovascular structure is the anterior portal, associated laterally with the femoral cutaneous nerve, presenting a higher risk of injury. Medial portals have a higher risk of injuring the femoral neurovascular bundle as well as the obturator nerve.

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