The Safety And Availability Of Medial Approach For The Distal Femoral Fracture-a Cadaveric Dissection And MRI Study

Objectives: The lateral approach,which is the standard approach for the distal femoral fracture and only allowed lateral buttress,and with high rates of malunion,nonunion,dysfunction,malrotation,and implant failure.A few studies have described an approach on the medial side of the femur,hence there is little worthy information concerning possible vessels and nerves damage that is the worry for orthopedists.This study aims to determine the availability and safety of an anteromedial approach proposed to research the possibly injured anatomical structures by a human cadaver dissection study,and measure the distance between the femoral artery and the approach using T2 weighted MR images.Methods: A human cadaver dissection study on safety of the proposed approach and the vascular and neural structures of the medial side of the distal femur was conducted.Moreover we recruited 20 health adults as volunteers.We signed the intervals at 20 cm above the knee joint line in the distal thigh as the object,which was scanned via MRI.Then consecutive transversal sections using 2cm intervals were obtained.All sectioning layers were photographed,and the exact dimension between anteromedial approach signed and the femoral artery of the thigh that appeared on the photographs was documented and was the same for each plane.Result: There is a scope to undergo surgery safely,and considerable neurovascular structures suffer no injury in process of dissection.The shortest distance from the approach to femoral artery ranged from 23.34 to 25.05mm(average 24.93mm)(95% confidence interval: 22.54 to 26.35mm),where is approximately 10 cm away from the knee joint line.Conclusion: It is safe and availability to solve highly unstable complex distal femur fracture via an anteromedial approach.It can be considered as an alternative method for conducting these complicated traumas.