- See: Blood Supply
to Femoral Head and Neck;
- Anatomy:
- mainly supplied by
profunda femoris:
- although there is variation,
nutrient artery usually enters bone proximally
and posteriorly along the linea aspera;
- usually there is only one nutrient artery (maximum of 2);
- usually it comes of the 2nd
perforating artery :
- after giving off
nutrient artery
thru its lower 3-4 cm;
it then pierces tendons of
adductor brevis
& magnus
- after penetrating posterior cortex, nutrient artery arborizes
proximally and distally to provide endosteal circulation to shaft;
- most of
periosteal vessels also enter bone along linea aspera;
- supply the outer 1/4 of cortex, esp. posteriorly at linea aspear;
- they align themselves perpendicularly to cortical surface w/ few, if
any, transversing along the periosteum longitudinally;
- because of this perpendicular orientation of periosteal vessels,
they are seldom extensively stripped during frx except during
severe open injuries;
- following diaphyseal frx, circulatory pattern is radically altered;
- frx w/ major displacement:
- result in complete disruption of medullary vessels;
- proliferation of
periosteal vessels is the key vascular response to frx &
is primary source for blood healing
- supplies outer 1/2 of cortex;
-
medullary supply is eventually restored late in healing;
- what are effects of IM rodding of femur:
- theoretically prevents resotoration of normal endosteal flow
during fracture healing;
- cylindrical or tubular nails that completely fill canal can have
deliterious effect on medullary flow;
- this may be as significant as arterial damage from frx;
- hence, many commercial nails have a non circular design w/
slotted to
provide potential space;
- ascending branch of
LFCA : supplies the front of femur;
