
 - See:
- See: - Anastomosis of lower limb arteries
- Arterial supply of the femur
- AVN of femoral head;
- AVN following femoral neck fracture
- Anatomy: 
    - extracapsular arterieal ring at the base of the femoral neck; 
         - formed posteriorly by large branch of MFCA 
         - formed anteriorly by smaller branches of LFCA; 
         - superior & inferior gluteal artery have minor contributions; 
    - ascending cervical branches 
         - these give rise to retinacular arteries; 
         - gives rise to subsynovial intra articular ring 
    - artery of ligamentum teres; 
         - derived from obturator or MFCA; 
         - inadequate to supply femoral head with displaced fractures; 
         - forms the medial epiphyseal vessels; 
         - only small & variable amount of the femoral head is nourished by artery of ligamentum teres; 
         - ref: The ligamentum teres of the adult hip
    - epiphyseal blood supply: 
         - arises primarily from lateral epiphyseal vessels that enter head posterosuperiorly; 
         - vessels from medial epiphyseal artery entering thru ligamentum teres; 
         - epiphyseal arterial branches: 
              - arise as arteries of subsynovial intraarticular ring; 
              - two groups of epiphyseal arteries: lateral & inferior vessels; 
    - metaphyseal blood supply: 
         - arises from extracapsular arterial ring; 
         - arise from branches of ascending cervical arteries, & subsynovial intra articular ring; 
- Changes w/ Age: 
    - even after closure of epiphyseal plate, there is minimal astomosis between epiphyseal and metaphyseal circulations; 
    - in the adult, greatest portion of blood supply to head of femur is derived from vessels on posterior superior surface of femoral neck; 
- Femoral Neck Frx: 
     - frx disrupts intraosseous cervical vessels; 
     - portion of the neck that is intracapsular has essentially no cambium layer in its fibrous covering to participate in peripheral
           callus formation; 
           - hence, healing is dependent on endosteal union alone; 
     - femoral head nutrition is then dependent on remaining retinacular vessels, & supply from the ligamentum teres; 
     - position acheived at reduction is significant factor in development of avascular necrosis: 
           - in frx of hip, valgus reduction may end up kinking of lateral epiphyseal vessels & tethering of medial epiphyseal
                    vessels in ligamentum teres; 
           - valgus and rotatory malposition may result in AVN 
The relative contribution of the medial and lateral femoral circumflex arteries to the vascularity of the head and neck of the femur: a quantitative MRI-based assessment.
Intracapsular pressure and caput circulation in nondisplaced femoral neck fractures.
The arterial supply of the developing proximal end of the human femur.
Vascularity of the hip labrum: a cadaveric investigation.
Capsular and Pericapsular Contributions to Acetabular and Femoral Head Perfusion
Vascular Supply to the Acetabular Labrum
 
					