An emergency physician performs a venous cutdown at the ankle in a shocked child. The vein used lies consistently anterior to the medial malleolus. Which vein is this, and where does it terminate proximally?

• A Small saphenous vein, draining into the popliteal vein
• B Small saphenous vein, draining into the femoral vein at the saphenous opening
• C Great saphenous vein, draining into the popliteal vein
• D Great saphenous vein, draining into the femoral vein at the saphenous opening ✓

Explanation

The great saphenous vein passes reliably anterior to the medial malleolus, making it the standard site for cutdown, then ascends medial to the knee and thigh to pierce the cribriform fascia at the saphenous opening and drain into the femoral vein about 2.5 cm below and lateral to the pubic tubercle. The small saphenous vein lies behind the lateral malleolus and drains into the popliteal vein, so both features of option A and the mixed pairings in C and B are incorrect.

Reference: Moore's Clinically Oriented Anatomy, 9th ed.

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