Blood supply of the femoral head detailed lecture youtube. Blood supply to the femoral head and neck wheeless textbook of. Considerable material has also been obtained at the autopsy table and from the dissecting room for further study in regard to the source of the blood supply to the head and neck of the femur. Avascular necrosis an overview sciencedirect topics. The principal vessels ascend in the synovial retinaculum, which is a reflection of the ligamentous capsule onto the neck of the femur. Nonc of the children were known to have had signs or symptoms in the hips hcforc death. Regarding the vascular anatomy of the hip, the literature presents few studies. Photograph during cadaver dissection showing the anterior view of the right inguinal region, with the main trunk of the medial femoral circumflex artery arrow originating from the deep femoral artery. Unlike other joints in the body, the femoral head has a very unique but precarious blood supply where almost all the blood going to the femoral head is delivered by one main blood vessel system that must enter the femoral head by travelling across the femoral neck into the hip joint and finally into the head at its junction with the femoral neck. The main blood supply to the femoral head is from the medial and lateral femoral circumflex arteries that are large branches of either the femoral or profundafemoris arteries. The femoral head receives arterial blood flow from an anastomosis of three sets of arteries.
Avascular necrosis or osteonecrosis is a condition affecting the upper part of the leg specifically the femoral head. The alt does not penetrate the epiphysis of the femoral head until age 9 or 10 years. Pdf the inferior gluteal artery is described in standard anatomy textbooks as contributing to the blood supply of the hip through an. Get a printable copy pdf file of the complete article 480k, or click on a page image below to browse page by page. The blood supply of the femoral head has been summarized by trueta and harrison 1953, sevitt and thompson 1965 and judet and collaborators 1981 after decades of research fig. Blood supply of the femoral head europe pmc article. The arterial supply to the head of the femur has hitherto been studied almost exclusively in anatomic specimens and a report of the examina tion of these vessels in uiuo, particularly in conditions which may give rise to aseptic necrosis of the femoral head, may consequently be of interest. A simple illustration of blood supply of femoral head and talus slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Profunda femoris deep femoral aterymed and lat circumflex then artery to the head of the femur branch of obturator arterywithin ligament of head of femur. Assessment of residual blood supply after femoral neck fracture in adults based on. Current concepts on osteonecrosis of the femoral head. In its intraarticular course, it divides into 15 posterior superior nutrient arteries of the femoral head, continuing within the retinaculum toward the femoral head 9, 10, 12 fig. Lesions of the femoral neck may interfere with the blood supply to the femoral capital epiphysis resulting in avascular necrosis. The hip joint is a ball and socket type of synovial joint that connects the pelvic girdle to the lower limb.
The first page of the pdf of this article appears above. Blood supply to the chicken femoral head article pdf available in comparative medicine 604. Description of the anastomosis between the medial femoral circumflex artery and inferior gluteal arteries at the hip. Ascending cervical branches arise from ring at base of neck.
The head is globular and forms rather more than a hemisphere, is directed upward, medialward, and a little forward, the. The femoral head femur head or head of the femur is the highest part of the thigh bone femur. The normal vascular anatomy of the human femoral head during growth. Blood supply of femoral head and talus linkedin slideshare. Reinforced by the superior and inferior gluteal arteries internal iliac a. Supplemental flow to the femoral head is supplied by the artery of the ligamentum teres, a branch of the obturator artery. Vascular anatomy and blood supply to the femoral head. Micro perfusion and quantitative analysis of the femoral head.
The femoral head receives blood from three sources. Pdf download for anatomic study on the blood supply to the femoral head. Blood supply medial femoral circumflex artery mfca main blood supply to the weightbearing portion of the femoral head. Anatomic study on the blood supply to the femoral head following.
Effects of hip traction on the blood supply of femoral. Another source of blood supply, also originating from the mfca, is the posterior inferior nutrient artery. The blood supply to the proximal femur internal fixation. The aim of this study was to investigate femoral head. The mediab circumflex artery springs from the deep femoral artery, traverses. Avascular necrosis of the capital femoral epiphysis after intramedullary nailing for a fracture of the femoral shaft.
Blood supply of the femoral head pubmed central pmc. In this joint, the head of the femur articulates with the acetabulum of the pelvic hip bone the hip joint is a multiaxial joint and permits a wide range of motion. It typically affects relatively young, active people between 20 and 40 years and. Pdf the surgical anatomy of the blood supply to the femoral head. Over time, healing occurs by new blood vessels infiltrating the dead bone and removing the necrotic bone which leads to a loss of bone mass and a weakening of the. It can lead to pain and limping, hip collapse, and cause the legs to be of unequal length. If you like our videos please do not forget to like, comment, subscribe to the channel.
Because bone cells need a steady supply of blood to stay healthy, osteonecrosis can ultimately lead to destruction of the hip joint and severe arthritis. Green oval transition point between the extracapsular and intracapsular portions. If you continue browsing the site, you agree to the use of cookies on this website. The development of anfh is associated with steroid use, alcohol use, smoking, autoimmune disorders.
Osteonecrosis on of the femoral head onfh is the final common pathway of a series of derangements that result in a decrease in blood flow to the femoral head fh leading to cellular death, fracture, and collapse of the articular surface1,2. The normal vascular anatomy of the femoral head in adult man. From this distal attachment, capsular fibres are reflected on to the femoral neck as retinacula and provide one pathway for the blood supply to the femoral head 4the capsule of the hip is attached proximally to the margins of the acetabulum distally, it is attached along. Ring is formed by branches of medial and lateral circumflex femoral arteries. Penetrate capsule near its femoral attachment and ascend along neck. Nonhodgkinslymphoma ofbone causing avascular necrosis. Observations were also made in reference to the part the ligamentum teres had to play in carrying nourishment to the femoral head. The right femoral head in supply to the epiphysis of the head of thc femur. Blood supply to the femoral head and avascular necrosis. The blood supply of the femoral neck and head in relation to the damaging effects of nails and screws. To evaluate the bleeding of the femoral head on hip osteoarthritis in patients who. When such changes are present on a radiograph especially in children over the age of 12 perthes disease is unusual over this age and the metaphyseal lesion in perthes is nearly always located well forward on the meta. From the anastomoses that contribute to the blood supply of the femoral head, the most important is the anastomosis with the iga via the piriformis.
Age 48 blood from separate epiphyseal vessels as the physis is barrier to blood flow. Acetabular lip or labrum, fibrous dense and strong, covers entire femoral head and neck. The surgical anatomy of the blood supply to the femoral head. Originates from an extracapsular arterial ring, supplied by medial and lateral circumflex vessels profunda femoris a. Osteonecrosis of the hip is a painful condition that occurs when the blood supply to the head of the femur thighbone is disrupted.
The effect of femoral neck fractures on femoral head blood. Young, male neutered, obese cats are predisposed to sustaining spontaneous capital physeal fractures, as well as fractures of the femoral neck secondary to metaphyseal osteopathy. Avascular necrosis of the femoral head physioworks. Avascular necrosis of the femoral head anfh is a degenerative condition which causes the upper ends of the thigh bones femurs to break down due to a disrupted blood supply and poor bone repair. Femoral head osteonecrosis is a condition caused by a compromise of the blood supply of the femoral head. The blood supply to the femoral head is especially. The medial circumflex artery, a branch of the profunda femoris artery, penetrates into the femoral proximal metaphysis but is prevented from passing into the femoral epiphysis by the growth plate. Articles blood supply of the femoral head br med j 1953.
Many authors agree that the deep branch divides into the terminal nutrient arteries in all cases 215. Precise understanding of the major vascular branches to the femoral head would allow for complete or selective ligation of its blood supply and enable the creation of a reproducible bipedal model of femoral head osteonecrosis. The traditional piriformis start site causes injury to the blood supply to the femoral head and must be avoided when rigid nail fixation is used in skeletally immature individuals. The nutrition of the femoral head is furnished by the medial circurn flex artery of the thigh and the artery of the ligamentum teres. A short lecture but detailed for femoral head blood supply. Total crosssectional area of the femoral neck nutrient foramina. Avascular necrosis avn is a disease where there is cellular death of bone component due to interruption of the blood supply. The arterial supply to the femoral head in children. Essentially, the femoral head or ball of your hip joint receives less and less blood supply. The precarious blood supply of the head and its role as a major weightbearing joint makes it one of the most common bones to be affected by osteonecrosis. Posterior superior nutrient arteries are the most important source of blood supply. Of these two, the medial is usually the from the department of orthopaedic surgery, university of pennsylvania school of medicine, philadelphia, pa.
Links to pubmed are also available for selected references. A detailed understanding of the blood supply to the femoral head is. The lateral epiphyseal vessels branches of the medial femoral circumflex artery and vein, that normally play an important part in the vascularization of. Arterial blood supply to the femoral head is achieved through an anastomosis of three sets of arteries figure 6. Blood supply of the femoral head is derived from 2 vascular systems the posterosuperior and the posterioinferior from multiple small vessel supply at birth these two vascular system evolve over 1824 months these are from the medial circumflex artery. Basic sciences blood supply of the femoral head youtube. Familial avascular necrosis of the femoral head genetic. Get a printable copy pdf file of the complete article 1. Damage to blood supply from anterior capsulotomy vs. Orthopaedic guidance for dnb orthopaedics,ms orthopaedics and mrcs exams. Full text full text is available as a scanned copy of the original print version. Blood flow to the proximal femur is supplied primarily by the branches of the medial and lateral circumflex femoral arteries. Pdf file of the complete article 480k, or click on a page image below to browse page by page. Age 8 the ligamentum teres has increasing significance in supply 20% trueta suggested that did not supply until 3.
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