The Journal of Bone and Joint Surgery, Vol 58, Issue 7 961-970, Copyright © 1976 by Journal of Bone and Joint Surgery, Inc
The arterial supply of the developing proximal end of the human femur
SM Chung
By means of perfusion studies, an analysis was made of the arterial supply
to the proximal end of the femur in 150 specimens from autopsied fetuses
and children, aged from twenty-six weeks of gestation to fourteen years and
eight months old. All died of diseases which did not involve the hip joint.
Two anastomotic rings were found: an extracapsular one formed by the medial
and lateral femoral circumflex arteries, and a subsynovial intra-articular
ring at the articular cartilage-neck junction. The intra-articular rings in
males were discontinuous more often than in females. A three-plane analysis
of totally-cleared specimens demonstrated that the epiphyseal plate
constituted an absolute barrier to blood flow between the epiphysis and
metaphysis in all but two of the 124 barium sulphate-perfused specimens
examined. A smaller number of ascending cervical arteries crossed the
anterior and medial surfaces of the mid-neck in the specimens from three to
ten-year-old white children than in those from newborn to two-year-old
white and black children. This finding may be important for the etiology of
Legg-Perthes disease. No differences with respect to age, sex, or race were
found in the arteries of the ligamentum teres.
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