- See:
- Epiphyseal Artery
- Metaphyseal Artery
- Periosteal Artery
- Discussion:
- nutrient artery enters into the diaphysis of long bones through an oblique canal;
- direction of canal is determined by relative amount of growth that has occurred at proximal and distal ends of the bone;
- nutrient canals slope away from the knee in femur, tibia, and fibula and towards elbow in radius, ulna, and humerus;
- does not branch within the cortex.
- nutrient artery divides after reaching the medullary cavity, sending arteriole branches in proximal and distal directions and join w/ metaphyseal arteries
- vessels radiate from these medullary arteries to the cortex, and drain to venules on the periosteal surface of the bone;
- direction of blood flow is from endosteum to periosteum;
- intramedullary pressure is higher than periosteal surface allowing of egress of intersitial fluid in cortex;
- some of these branches enter cortex to supply haversian canals of inner two thirds of the cortex;
- other branches of nutrient artery continue in more or less parallel alignment to metaphysis;
- in the child, these vessels end on metaphyseal side of epiphyseal plate, where they participate in enchondral ossification;
- Disruption of Nutrient Artery:
- in growing bone can result in necrosis of large portion of marrow & of inner two thirds of cortex;
- this cortical death does not occur in adult bone because combined epiphyseal-metaphyseal collateral circulation is developed enough to maintain these areas;
- loss of circulation in terminal vessels of nutrient artery of growing bone will interfere w/ enchondral ossification
Early changes in nutrient artery blood flow following tibial nailing with and without reaming: a preliminary study.