Orthopaedic Surgeon, University of Toledo Medical Center
Monday, June 10, 2019
Femoral Triangle
The femoral triangle is a superficial triangular
space located on the anterior aspect of the thigh just inferior to the inguinal
ligament. The boundaries of the femoral triangle include the lateral border,
medial border, and base. The lateral border is formed by the medial border of
the Sartorius M. The Sartorius muscle is a thin, small muscle going that goes
from lateral to medial. The Sartorius muscle inserts on the medial side of the
proximal tibia. The medial border of the femoral triangle is formed by the
medial border of the adductor longus M. The adductor longus muscle goes from
medial to lateral direction. The base of the femoral triangle is formed by the
inguinal ligament. The floor of the triangle is formed by the iliacus M., psoas
major M., pectineus M., and the adductor longus M. The roof of the femoral
triangle is covered by skin, superficial and deep fascia. The femoral triangle
contains three important structures. From lateral to medial, it is the femoral
nerve, femoral artery, and femoral vein, which contains deep inguinal lymph
nodes. The femoral nerve lies within the groove between the iliacus and psoas
major muscles. Two other nerves are located within the femoral triangle, and
they are the lateral cutaneous nerve on the thigh and the femoral branch of the
genitofemoral nerve. The lateral cutaneous nerve of the thigh crosses the
lateral corner of the triangle. It supplies the skin on the lateral part of the
thigh. The femoral branch of the genitofemoral nerve runs in the lateral
compartment of the femoral sheath. It supplies the majority of the skin over
the femoral triangle. The femoral triangle also contains the femoral sheath
which is a funnel shaped sleeve of fascia enclosing the upper 4 cm of the
femoral vessels. The neurovascular bundle is medial to the sartorius muscle.
Therefore, in the anterior approach to the hip, it is always safe to go lateral
to the sartorius muscle in order to avoid the important structures within the
femoral triangle. Do not go medial to the sartorius muscle. You will injure the
structures if you go medial to the sartorius muscle. It is important to
remember when performing this approach to avoid the lateral cutaneous nerve of
the thigh. The sartorius muscle is almost like the teres minor muscle in the
shoulder. Do not go inferior to the teres minor muscle in the shoulder, you
will injure the axillary nerve and the posterior circumflex artery.