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We examined the human vascular anatomy to the greater trochanter after digastric trochanterotomy, using some injection techniques and practiced the trochanterotomy (digastric, classic). We found 3 major sources of blood supply to the greater trochanter: the proximal soft tissues, including the gluteus medius and minimus, were mainly vascularized from the internal iliac artery system, and the distal soft tissues, including the vastus lateralis, were vascularized from the branches of the lateral circumflex femoral artery (LCFA). A third possible source of blood circulation came from the LCFA, but this branch was only found in 12 to 15 samples. Many vascular structures from the LCFA were concentrated in the anterior half of the vastus lateralis muscle which were deeply imbedded and ran upward to the trochanteric insertion of the vastus lateralis muscle. The distance from the superior tip of the greater trochanter to the point at which the first branch of the descending branch of the LCFA enters into the vastus lateralis muscles was from 65 mm. to 125 mm. The descending branch was found consistently in all 20 samples. Our results proved that with digastric trochanterotomy, we can preserve all three sources of vascularization whereas with classic trochanterotomy the supply from the transverse and descending branches of the LCFA are lost.

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.