Vascular Safe Zone During Percutaneous Pinning of the Distal Femur

This study describes a radiologic vascular safe zone that is easily visualized during surgery (wherein the superficial femoral vessels are safely posterior). Methods: Patients ≤16 years old with magnetic resonance imaging of one or both femora between 2005 and 2020 were retrospectively reviewed. The “at-risk level” (ARL) was defined as the distal-most axial image with a femoral vessel anterior to the posterior condylar axis. A standardized retrograde lateral-to-medial pin was templated. A correlation matrix and least squares regression identified age and physeal width (PW) as ideal independent variables. A vascular safe zone above the medial femoral condyle (MFC) was modeled as a multiple of PW (i.e. x*PW) and needed to satisfy 3 age-dependent criteria: (1) at the ARL, the pin is medial to the vessels, (2) the pin exits the medial thigh before the ARL, and (3) the chosen “vascular safe zone” (x*PW) is always distal to the ARL. Results: Forty-three patients averaging 7.1±3.9 (0.3-16) years old were included. Intra-Class correlation coefficients were excellent (0.92-0.98). All measurements strongly correlated with age (r=0.76-0.92, P
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Trauma Source Type: research