Blood supply of proximal part of the femur is derived from following sources
Ascending cervical vessels arise from the extracapsular ring of anastomosis formed by the medial and lateral circumflex femoral artery at base of neck. Ascending Cervical Branches travel proximally under the hip capsule and continue proximally along neck deep to synovial membrane
toward the femoral head.
These arteries are known as retinacular arteries and are divided into three groups
- Posterior inferior & posterior superior (from medial femoral circumflex artery)
- Anterior (from lateral femoral circumflex artery)
at margin of of articular cartilage on surface of the neck of femur, these vessels form second ring called subsynovial intra articlar ring from which arise epiphyseal arteries.
The intramedullary branches of nutrient [arise from from upper perforating arteriest of the profunda femoris], metaphyseal [Arise from medial circumflex and extracapsular arterial ring and subsynovial ring] and epiphyseal vessels [Arise from subsynovial ring] feed both marrow and cortical bone. If the fracture of neck of femur is complete, this supply gets disrupted.
Artery of Ligamentum Teres
It is a branch of the medial circumflex femoral artery and supplies the head of femur through ligamentum teres. it also forms the medial epiphyseal vessels. Only small & variable amount of the femoral head is supplied by artery of ligamentum teres.
- Medial femoral circumflex artery arises from posteromedial aspect of deep femoral artery
- Lateral femoral circumflex usually arises from lateral side of deep femoral artery