Background: Failure to disconnect the saphenopopliteal junction (SPJ) can occur in spite of duplex marking prior to operation indicating that more information on the short saphenous vein (SSV) termination in addition to the duplex mark is necessary to improve operative outcomes. The aim of this study was to establish the three-dimensional anatomy of the SSV termination to aid in improving operative localization of the SSV and SPJ.
Method: A prospective colour duplex study of 50 consecutive primary refluxing SSV was undertaken. The spatial orientation of the SSV termination in terms of location within the popliteal fossa and depth from the skin was determined.
Results: The SPJ was located in most cases (98%) in the upper lateral quadrant of the popliteal fossa. The median depth of the SPJ beneath the skin was 2.9 (1.6–5.2) cm. The SSV leaves the midline at a distance of approximately 5 (0–8) cm below the midpoint of the popliteal fossa and travels laterally towards the SPJ. It stays close to the skin and makes the descent into the fossa at 2–3 cm below the SPJ. The mean rate of descent between the SPJ and 2 cm below it was 7.0 (1–12) mm/cm, while that between 2 and 4 cm below the SPJ was only 2.3 (0–7) mm/cm.
Conclusion: The SPJ lies at a variable depth beneath the skin in the upper outer quadrant of the popliteal fossa. Locating the incision 2 cm below and medial to the SPJ, where the SSV lies relatively superficial and at a less variable depth, will allow easier identification of the SSV and thus easier localization of the SPJ.
