Why Venous Ulcers Commonly Occur Over the Medial Aspect of the Distal Leg?

Chronic venous insufficiency is a common disorder of legs. Most of the people with chronic venous insufficiency presents with varicose veins or with venous ulcer. One of the complication of varicose veins is lipodermatosclerosis of the medial aspect of the distal part of the leg. In lipodernatosclerosis the  skin gets hyperpigmented, edematous, purplish or reddish with or without ulceration. 

Even though lipodermatosclerosis can occur over the lateral part of the leg as well, the commonest site is the medial site. This is due to the presence of incompetent posterior arch vein perforaters which are present over the medial aspect of the tibia.