We attempted to determine the relationship between the cephalic vein and the sensory branch of the radial nerve at the wrist to help prevent lesions of the radial nerve when the cephalic vein is cannulated. We examined the anatomy of 33 postmortem specimens and suggest that puncture of the cephalic vein 12 cm or more proximal to the styloid process can prevent radial nerve lesions.
Using a series of 20 dissections and two anatomic transverse sections of a lower limb, the authors investigated the lateral approaches to the popliteal artery. The high lateral approach (above the knee) is not very aggressive and gives access to the retro-genicular part of the popliteal artery. After cutaneous and fascial incision, a simple gap between the vastus lateralis and biceps femoris mm. allows easy exposure of the popliteal vessels after backward retraction of the sciatic nerve. The low lateral approach to the artery (below the knee) is very aggressive for the vessels, nerves, and ligaments of the area. It involves the resection of the upper fourth of the fibula and the isolation and protection of the common peroneal nerve Nevertheless, these lateral approaches must be known and used when classic approaches (medial and posterior) are impossible.
The deep plantar artery is the main anastomosis between the dorsal and plantar arterial systems of the foot; with no change of calibre it unites the dorsalis pedis artery to the deep plantar arch, the second segment of the lateral plantar artery, passing into the first intermetatarsal space. Our anatomic study of 20 dissections of the deep plantar artery allowed us to verify the near-constancy of its descriptive anatomy and relationships. The deep plantar artery, when present, only found in 16 of our 20 cases, is totally linked to the dorsalis pedis artery. Its easy accessibility via the dorsal route, its medium calibre and the absence of collateral branches make this artery a possible anatomic site for the performance of a distal bypass, the last option before an amputation of the foot becomes necessary, although such a case remains exceptional.
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