Femur: Given the medial and posterior location of neurovascular structures in the thigh, an anterolateral or lateral approach can be used with little risk to neurovascular structures. At the distal third of the femur, however, care should to be taken to avoid over-penetration of the posterior cortex, as this risks injury to the popliteal artery. Anterior pins placed in the distal femur should begin 7.5 cm above the superior pole of the patella to avoid inadvertent intraarticular placement.23