A 60-year-old woman with chronic venous insufficiency has an indolent ulcer just above the medial malleolus. Doppler shows an incompetent communicating vein piercing the deep fascia about 13 to 15 cm above the medial malleolus, connecting the great saphenous vein to posterior tibial veins. Which perforator is this?
- A Boyd's perforator, just below the knee
- B Cockett's perforator, lower leg ✓
- C Dodd's perforator, mid-thigh
- D Sherman's perforator, upper calf
Correct answer: B. Cockett's perforator, lower leg
Explanation
Cockett's perforators lie in the lower third of the leg around 13 to 15 cm above the medial malleolus and connect the great saphenous system to the posterior tibial veins. Incompetence here produces the classic gaiter area venous ulcer above the medial malleolus. Boyd's perforator lies just below the knee, Dodd's in the distal thigh, and Sherman's in the upper calf, so their locations do not match the ultrasound finding described.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.