A STUDY ON THE ANATOMICAL VARIATIONS IN THE MEDIAL CIRCUMFLEX FEMORAL ARTERY

Address for Correspondence: Dr. S. Elizabeth Priyadarisini, Assistant Professor of Anatomy, Stanley Medical College, Chennai, Tamilnadu, India. E-Mail: drelizabethmmc@gmail.com INTRODUCTION International Journal of Anatomy and Research, Int J Anat Res 2017, Vol 5(2.3):3934-37. ISSN 2321-4287 DOI: https://dx.doi.org/10.16965/ijar.2017.223 Access this Article online Quick Response code Web site: International Journal of Anatomy and Research ISSN 2321-4287 www.ijmhr.org/ijar.htm DOI: 10.16965/ijar.2017.223 1 Assistant Professor of Anatomy, Stanley Medical College, Chennai, Tamilnadu, India. 2 Professor and HOD of Anatomy, Stanley Medical College, Chennai, Tamilnadu, India. Received: 17 Apr 2017 Peer Review: 17 Apr 2017 Revised: None Accepted: 23 May 2017 Published (O): 30 Jun 2017 Published (P): 30 Jun 2017 Background: The medial circumflex femoral artery(MCFA) is a medial branch of the profunda femoris artery(PFA), but in some cases it originates from the femoral artery(FA).It is a vital artery supplying the head and neck of femur.It is very important to avoid its injury in hip surgeries to prevent necrosis of the femoral head. Materials and Methods: Fifty adult lower limb specimens were obtained from the embalmed cadavers at the department of Anatomy, Stanley Medical College, Chennai. The femoral triangles were dissected ,the femoral artery and its main branch, the profunda femoris artery were exposed completely. The lateral and medial circumflex branches of the PFA were dissected and identified.The origin of the MCFA from the profunda femoris and variations present in its origin were studied and photographed. Results: The MCFA arose from the PFA in 32 specimens(64%) and from the FA in 18 cases(36%). In 2 cases(4%) the MCFA after arising from the PFA immediately divided in to three branches in the femoral triangle itself.Out of 18 cases in which the MCFA originated from the FA,in 2 specimens(4%) the MCFA and PFA originated as a common trunk(CT) from the femoral artery.In 4 cases (8%) the MCFA arose from the FA superior to the origin of deep external pudendal artery (DEPA).In 2 specimens(4%) the MCFA after originating from the femoral artery divided in to two branches in the femoral triangle itself. Conclusion: The knowledge of MCFA origin and branching pattern is helpful in preventing iatrogenic injury to these vessels during surgical procedures in the hip joint and femoral triangle.

artery supplying the head and neck of femur, adductor thigh muscles and adipose tissue in the acetabular fossa [2,3].It forms the cruciate anastomosis in the intertrochanteric fossa through which the circulation of the lower limb is accomplished in case of an occlusion of the femoral artery [4,5].Precise knowledge of this artery is needed when performing trochantericand intertrochanteric osteotomies and it is The medial circumflex femoral artery (MCFA)is a branch of the profunda femoris artery.It arises from the profunda femoris artery(PFA) near its origin, goes posteriorly out of the femoral triangle, and then proceeds to the upper border of the adductor magnus, where it ends by dividing into transverse and ascending branches [1].
Medial circumflex femoral artery is a vital also helpful to avoid iatrogenic vascular necrosis of the head of femur in reconstructive surgeries of the hip joint [6].
The MCFA is used in selective arteriography in case of idiopathic ichaemic necrosis of the femoral head in order to determine the arterial blood supply of the femoral head [7].MCFA is used in flap plastic surgeries as a vascular pedicle content such as transverse upper gracilis flap and medial circumflex femoral perforator free flap [8,9].

MATERIALS AND METHODS
Fifty adult lower limb specimens were obtained from the embalmed cadavers at the department of Anatomy, Stanley Medical College, Chennai, Tamilnadu, India.
The femoral triangles were dissected ,the femoral artery and its main branch in the femoral triangle, the profunda femoris artery were exposed completely.The lateral and medial circumflex branches of the PFA were dissected and identified.The origin of the MCFA from the profundafemoris and variations present in its origin were studied and photographed.
The MCFA arose from the PFA in 32 specimens (64%) and from the FA in 18 cases (36%).In 2 cases (4%) the MCFA after arising from the PFA immediately divided in to three branches in the femoral triangle itself.
Out of 18 cases in which the MCFA originated from the FA, in 2 specimens (4%) the MCFA and PFA originated as a common trunk(CT) from the femoral artery.In 4 cases (8%) the MCFA arose from the FA superior to the origin of deep external pudendal artery (DEPA).In 2 specimens(4%) the MCFA after originating from the femoral artery divided in to two branches in the femoral triangle itself.The MCFA arose from PFA in 64% and from the femoral artery in 36%.In 2 cases(4%) the MCFA after arising from the PFA immediately divided in to three branches in the femoral triangle itself.The table below gives a comparison of the present study with other studies in the literature on the site of origin of MCFA.arthroplasty.This study will be helpful to surgeons and orthopaedicians to avoid its injury during hip surgeries and thereby prevent necrosis of the femoral head.

Fig. 5 :
Fig. 5: Medial circumflex femoral artery from the profunda femoris dividing into three branches in the femoral triangle.

Fig. 6 :
Fig. 6: Origin of medial circumflex femoral artery from the femoral artery above deep external pudendal artery.

Fig. 7 :
Fig. 7: Origin of medial circumflex femoral artery from the femoral artery above deep external pudendal artery.

Fig. 8 :
Fig. 8: Medial circumflex femoral artery arising from the femoral artery dividing into two branches in the femoral triangle.

FA
ABBREVIATION

Table 1 :
Site of origin of MCFA.

including common stem) Siddharth P et al (1985) [10]
Common trunk origin of MCFA with PFA from the femoral artery was 4% in the present study,but in Samarawickrama study it was 8% , inTanyeli et al study(2006)it was 2% and in Daksha et al study it was 14%.

Table 2 :
Origin of MCFA from FA-CT with PFA.
There is a high risk of damage to the MCFA after trauma and surgeries such as total hip CONCLUSION S.