Surgical anatomy of the veins of the lower limb – a cadaveric study

Introduction: With the advent of new surgical techniques, an adequate knowledge of
precise anatomy of the venous system of the lower limb is important for safe surgery.
The aim of this study is to provide some basic information for those who are interested
in phlebology.
Materials and methods: The anatomy of the superficial and deep veins of both lower
limbs was studied in 20 human cadavers (age 42-72 years) of both sexes (12 males:
08 females). Great saphenous vein (GSV) and small saphenous vein (SSV) were traced
from medial and lateral malleoli to the sapheno-femoral junction (SFJ) and saphenopopliteal
junction (SPJ) respectively. The number of deep perforators was counted and
measurements were taken from a fixed anatomical land mark.
Results: In both lower limbs of 17 cadavers (85%), the course of GSV was similar to
the course described in the commonly used text books. Large tributary with a diameter
similar to GSV at the SFJ was seen in 3 cadavers (15%). The point of entry of SSV into
the popliteal vein varied greatly. In majority of cadavers the opening was at the level of
the popliteal skin crease and in others it was either above or below this. Large deep
perforators were found in the calf and thigh with irregularly distributed small perforators.
Conclusion: A majority of individuals have the lower limb superficial venous pattern
described in standard text books. However, a significant minority had variations, which
could have important implications on the presentation and treatment of varicose veins.

DOI: 10.4038/sljs.v27i2.2099

The Sri Lanka Journal of Surgery 2009: 27: 45-47