- see bone circulation
- blood supply to tibial shaft is dervied from nutrient artery & periosteal vessels;
- nutrient artery
- arises from posterior tibial artery
as it enters into the posterior tibial cortex, distal to the soleal line at the middle 1/3;
- enters posterolateral cortex of the tibial at the origin of the soleus muscle;
- artery may transverse distance of 5.5 cm before entering its oblique nutrient canal;
- artery divides into three ascending branches & a single descending branch, which gives off smaller brances to the endostreal surface;
- provides the endosteal blood supply to the inner tibial cortex;
- may be damaged in segmental frx;
- this makes bone dependent on soft tissue envelope for blood supply, & stripping of soft tissues may render the bone avascular;
- anterior tibial artery
- may be vulnerable to injury after its division from popliteal artery, where it passes thru hiatus in upper interosseous membrane;
- periosteum has abundant blood supply from anterior tibial artery
branches as it courses down interosseous membrane
Anatomy of the microvasculature of the tibial diaphysis of the adult dog
Measurement of blood flow in tibial fracture patients using positron emission tomography
The Surgical Anatomy of the Principal Nutrient Vessel of the Tibia
Blood supply of the human tibia.
Tibial blood supply in relation to fracture healing.
Blood supply and the rate of healing of tibial fractures.
Original Text by Clifford R. Wheeless, III, MD.