Arterial supply to Femur



- 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



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, August 19, 2011 12:37 pm