Abstract
Precise knowledge of the vascular supply of the femoral head is critical when contemplating surgery around the femoral head and neck junction. To determine the blood supply to the femoral neck, 2417 nutrient foramina from 76 cadaveric specimens were analyzed based on size, number, and distribution. Within the subcapital, transcervical, and basicervical regions of the femoral neck, the largest numbers of nutrient foramina were found on the superior (lateral) surface, followed by the anterior and posterior surfaces, and then the inferior (medial) surface (all p < 0.001). The diameters of most of the nutrient foramina were less than 1 mm. For the posterior and superior surfaces, the nutrient foramina in the basicervical region were significantly larger than those within the transcervical or subcapital regions (nutrient foramina >2 mm posteriorly: 23.6, 12.7, and 9.0 % in the basicervical, transcervical, and subcapital regions, respectively; superiorly: 23.7 vs. 15.4 vs. 16.8 %, respectively). In conclusion, neither the anterior nor the inferior surfaces in the basicervical, transcervical, and subcapital regions showed any significant differences in nutrient foraminal size. The areas containing densely distributed nutrient foramina were consistent with the regions covered by the retinacula of Weitbrecht.
Highlights
Precise knowledge of the vascular supply to the femoral head is critical when contemplating surgery in the region surrounding the femoral head and neck junction (Lavigne et al 2005)
The diameters of most of the nutrient foramina were less than 1 mm
The areas containing densely distributed nutrient foramina were consistent with the regions covered by the retinacula of Weitbrecht
Summary
Precise knowledge of the vascular supply to the femoral head is critical when contemplating surgery in the region surrounding the femoral head and neck junction (Lavigne et al 2005). The lateral ascending cervical branches of the MFCA are at risk of disruption. Loss of this blood supply increases the risk for avascular necrosis (AVN) of the femoral head (Canale 1998). Both the MFCA and LFCA give off branches from the joint capsule at the base of the femoral neck when passing through the retinacula of Weitbrecht to the femoral head and neck (Gojda and Bartonicek 2012). Disruption or distortion of these retinacular branches to the femoral head due to fracture displacement plays a significant role in the development of osteonecrosis (Arnoldi and Lemperg 1977)
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