The Hip: Preservation, Replacement and Revision

Bone Circulation:



- Discussion:
    - epiphyseal artery
    - metaphyseal artery
    - nutrient artery
    - periosteal vessels
    - see tibia bone circulation


- Pediatric Bone Circulation:
    - circulation in pediatric bone:
          - differs from adult circulation due to requirements of growth & presence of epiphyseal plate;
    - terminal branches of nutrient artery, along w/ metaphyseal vessels, approach growth plate in a parallel relationship;
    - branches are so numerous as they reach growth plate that there is almost one vessel for each column of cartilage cells;
           - in final few mm before terminal arteriole reaches cartilage, it is encased in a tube of enchondral bone;
           - as vessel extends to end of cartilage column, it makes abrupt 180 deg turn to enter larger venule;
           - slowing of the circulation may permit lodging & proliferation of bacteria to produce focus of hematogenous osteomyelitis;
    - function of metaphyseal blood supply (metaphyseal side of growth plate) is to provide nutrition for active cells involved in enchondral ossification;
    - epiphyseal vessels are essential for they supply dividing cells of growth plate & hence are responsible for maintaining longitudinal bone growth



The acute effects of periosteal stripping and medullary reaming on regional bone blood flow.



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

Last updated by Data Trace Staff on Monday, December 31, 2012 2:41 pm