THE ARTERIAL SUPPLY OF THE PROXIMAL END OF THE HUMAN FEMUR / 解剖学报

ABSTRACT

The arterial supply of the proximal end of the human femur in 100 specimens ranging in age from newborn to 67 years were studied by perfusion method. A complete extracapsular anastomotic ring, formed by both the medial and the lateral femoral circumflex arteries, was present surrounding the base of the femoral neck in 71％. An incomplete subsynovial intraarticular anastomotic ring, formed by the four ascending cervical arterial groups (medial, posterior, lateral and anterior), was present at the margin of the articular cartilage in 74％ of the specimens. There might be defect at anterior, posterior or both aspects. The lateral epiphyseal arteries, giving off many multiarcaded branches towards the articular cartilage, supplied the superior, medial, central and the lateral parts of the head. The medial ascending cervical arteries supplied the infero-posterior part of the head. The medial epiphyseal arteries supplied a limited subfoveal area. The nutrition of the free surface of the articular cartilage was derived from the vascular networks in the synovial membrane near the periphery of the articular cartilage and the fovea capitis femoris, and from the synovial fluid. The nutrition of its deep part near the chondro-osseous junction was derived from the looped epiphyseal capillaries. The superior metaphyseal arteries supplied the lateral two thirds of the neck. The medial, anterior and posterior ascending short cervical arteries supplied the corresponding areas of the neck. During the ossification of the chondroepiphysis the medial and lateral epiphyseal vessels and the medial ascending cervical artery established particular vascular anastomotic arch in the epiphysis. With epiphyseal plate closure in the adult the diaphyseal arteries crossed into the head, established free anastomoses with the epiphyseal arteries. The clinical significance of the topographical characteristics, the course and the distribution of the arterial supply to the proximal end of the femur were discussed.