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Arterial Supply to Femur

- See:
- Blood Supply Femoral Head & Neck

- Anatomy of Circulation:
- mainly supplied by profunda femoris:
- nutrient artery usually enters bone proximally and posteriorly along linea aspera;
- usually there is only one nutrient artery (maximum of 2);
- usually it comes of the 2nd perforating artery:
- after giving off nutrient artery thru its lower 3-4 cm;
- it then pierces tendons of adductor brevis & magnus;
- after penetrating posterior cortex, nutrient artery arborizes proximally & distally to provide endosteal circulation;
- most of periosteal vessels also enter bone along linea aspera;
- supplies outer 1/4 of cortex, esp posteriorly at linea aspear;
- they align themselves perpendicularly to the cortical surface rather than transversing along the periosteum longitudinally;
- hence,  femur frx are rarely devascularized except for severe injuries;
- damage to vessels is minimized by avoiding soft tissue stripping of the linea aspera;
- while extensive stripping for application of cerclage wires or tapes around shaft should be avoided, however, cerclage wires by themselves will not cause femoral devascularization since there is little or no longitudinal flow in the periosteal circulation;

- Circulation Following Frx:
- w/ displaced frx:
- results in complete disruption of medullary vessels;
- proliferation of periosteal vessels is paramount vascular response to the frx & is primary source for blood healing
- supplies outer 1/2 of cortex;
- medullary supply is eventually restored late in healing

The arterial supply of the developing proximal end of the human femur.