Three-Dimensional Vascular Anatomical Study of the Tensor Fasciae Latae Muscle and Perforators

Area of Science:

• Anatomy
• Vascular Surgery
• Medical Imaging

Background:

• Accurate vascular anatomy of the lateral circumflex femoral artery (LCFA) is crucial for harvesting tensor fasciae latae (TFL) muscle flaps.
• Existing literature presents conflicting information regarding the vascular supply to the TFL muscle and its overlying skin.
• Understanding the precise vascularization is essential for successful TFL flap procedures.

Purpose of the Study:

• To comprehensively evaluate the vascular anatomy of the TFL muscle.
• To determine the location, origin, type, caliber, and length of the vessels supplying the TFL muscle.
• To clarify the arterial supply and perforator characteristics for TFL flaps.

Main Methods:

• Study conducted on 16 human cadaver thighs injected with lead oxide and gelatin via the femoral artery.
• Whole-body computed tomography (CT) scans were performed, followed by 3D image reconstruction using Materialise Interactive Medical Image Control Software (MIMICS).
• Detailed anatomical dissection was performed to visualize the arterial supply and perforators of the TFL muscle.

Main Results:

• The ascending branch of the LCFA consistently served as the main arterial supply to the TFL muscle in all specimens.
• The mean diameter of the LCFA ascending branch was 2.7 mm (±0.4 mm) and its mean length was 3.6 cm (±0.6 cm).
• An average of 10.9 (±4) cutaneous perforators were identified, with musculocutaneous perforators present in all 16 specimens and septocutaneous perforators in 14.

Conclusions:

• The ascending branch of the LCFA is the principal vascular supply for the TFL muscle, providing both septocutaneous and musculocutaneous perforators.
• MIMICS software facilitates excellent 3D visualization and anatomical understanding of the TFL vascular supply.
• This detailed anatomical data is vital for planning and executing TFL flap surgeries.