Blood supply of the greater trochanter after trochanterotomy.

Abstract

The human vascular anatomy to the greater trochanter after a trochanterotomy (digastric, standard) was examined using injection techniques. Three major sources of blood supply to the greater trochanter were found: the proximal soft tissues, including the gluteus medius and minimus vascularized mainly from the internal iliac artery system; the distal soft tissues, including the vastus lateralis, vascularized from the descending branches of the lateral circumflex femoral artery; and a third possible source of blood circulation came from the transverse branch of the lateral circumflex femoral artery. Many vascular structures from the lateral circumflex femoral artery were concentrated in the anterior half of the vastus lateralis muscle. Perfusion with a latex oxide mixture and angiography after trochanterotomy proves that by using a digastric trochanterotomy, the transverse and descending branches of the lateral circumflex femoral artery to the greater trochanter thus can be preserved. With a standard trochanterotomy, the supply from the transverse and descending branches of the lateral circumflex artery are lost. These results therefore suggest that a digastric trochanterotomy is superior to a standard trochanterotomy because the blood supply of the trochanter is preserved.