Saphenofemoral Complex: Anatomical Variations and Clinical Significance

Varicosities of great saphenous vein (gsv) or its tributaries are a common medical condition present in up to 25% of adults. The gsv and its tributaries are located in a fascial compartment on the front of the thigh. There are great anatomical variations of these veins. However, the relation between these veins and the fascia lata on the front of thigh is even more variable and carries greater clinical importance. Forty cadaveric lower limbs were dissected to examine anatomical variations of these veins and describe their relation to the deep fascia of the thigh. Fascia lata of the front of the thigh split into superficial saphenous fascia and deep fascia lata proper. This fascial splitting formed the saphenous compartment. There were 3 types of saphenous compartment. Type 1 (30%), there was a triangular saphenous compartment containing the gsv and its tributaries. Type 2 (30%), there was a fascial canal containing the gsv. Type 3 (40%), there was a small fascial saphenous compartment with variable boundaries that contained the gsv and 1 or 2 of its tributaries. The number of superficial tributaries in the front of the thigh ranged from 3-7 with a mean of 5.12 ±1.95. The length of the gsv in the saphenous compartment ranged from 5-8.5 cm with a mean of 6.43±1.65 cm. The length of tributaries in the saphenous compartment ranged from 2-6 cm with a mean of 3.82±2.74cm. The external pudendal artery (epa) was intimately related to saphenofemoral junction (sfj) in 30% of cases. The cutaneous branches of the femoral nerve were related to the gsv, its tributaries and sfj in 52.5% of cases. Precise identification of the location of the gsv, its tributaries in relation to deep fascia of the thigh, epa and cutaneous nerves is crucial for planning appropriate surgical technique in case of varicosities