Relationship of femoral artery, vein and nerve projections with femoral head positions in patients with femoral neck fracture

doi:10.12307/2025.854

Abstract

Abstract: BACKGROUND: The blood supply to the femoral head is a significant factor affecting the prognosis of patients with femoral neck fractures. Therefore, a deep understanding of the femoral artery, vein, and femoral nerve is conducive to the smooth progression of closed reduction and internal fixation for femoral neck fractures.
OBJECTIVE: To obtain the projection and corresponding relations of femoral arteries, veins and femoral nerve on the femoral head by using the ultrasound to locate the position of femoral arteries, veins and femoral nerve.
METHODS: 195 patients with femoral neck fracture undergoing closed reduction and internal fixation treated between January 2014 and January 2020 were collected, among whom there were 108 females and 87 males, with an average age of 39.1 (23-65) years. There were Garden I in 13 cases, Garden II in 24 cases, Garden III in 90 cases, Garden IV in 68 cases, 99 cases on the left and 96 cases on the right as well as 55 cases of hypertension, 39 cases of diabetes mellitus, 15 cases combined with arrhythmia, and 9 cases with cerebral infarction. The ultrasound was applied to position the femoral vessels, femoral nerve and then mark their lines in the hip, and then Kirschner wire was placed on the marker line. The fluoroscopic imaging of Kirschner wire on the femoral head was used to obtain the relative relationship between the two. Zones A, B, C, and D were divided according to the tangent line of the medial and lateral margins of the femoral head and the perpendicular line of the central point of the femoral head.
RESULTS AND CONCLUSION: (1) The femoral arteries, veins and femoral nerves of 129 cases (66%) were located in the Zone A, 38 cases (20%) in Zone B, 28 cases (14%) in Zone C, and 0 cases in Zone D. Most of the femoral vessel and femoral nerve lines were overlapped with the medial projection of the femoral head, partial vessel and nerve lines overlapped with the femoral head projection, and there was no lateral projection of the femoral head. (2) Most of the femoral vessel and femoral nerve projection was located in Zone A, i.e., at the medial side of the femoral head. There was no vessel and femoral nerve projection at the lateral side of the femoral head, that was, Zone D was an avascular nerve area, so the needle entry at this area was absolutely safe. For the cases of femoral vessels and femoral nerve at the medial side of the femoral head, it was safe to insert the Kirschner wire vertically to fix the femoral head. (3) For the femoral vessels and femoral nerves in Zones B and C, the needle needs to be inserted at an angle to avoid damaging the vessels and femoral nerves.

Key words: femoral neck fracture, femoral artery, femoral vein, femoral head, position, femoral nerve, ultrasound, Kirschner wire, fracture implants

CLC Number:

Tang Yuntao, Wu Zhonghan, Wang Jingkun, Li Tao, Lu Jingtao, Mao Shitan, Tang Jian, Xu Xinzhong. Relationship of femoral artery, vein and nerve projections with femoral head positions in patients with femoral neck fracture[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(15): 3953-3959.

Figures/Tables 4

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