The terminal branches of the medial femoral circumflex artery: the arterial supply of the femoral head.
This study investigates and defines the topographic anatomy of the medial femoral circumflex artery (MFCA) terminal branches supplying the femoral head (FH). Gross dissection of 14 fresh-frozen cadaveric hips was undertaken to determine the extra and intracapsular course of the MFCA's terminal branches. A constant branch arising from the transverse MFCA (inferior retinacular artery; IRA) penetrates the capsule at the level of the anteroinferior neck, then courses obliquely within the fibrous prolongation of the capsule wall (inferior retinacula of Weitbrecht), elevated from the neck, to the posteroinferior femoral head-neck junction. This vessel has a mean of five (three to nine) terminal branches, of which the majority penetrate posteriorly. Branches from the ascending MFCA entered the femoral capsular attachment posteriorly, running deep to the synovium, through the neck, and terminating in two branches. The deep MFCA penetrates the posterosuperior femoral capsular. Once intracapsular, it divides into a mean of six (four to nine) terminal branches running deep to the synovium, within the superior retinacula of Weitbrecht of which 80% are posterior. Our study defines the exact anatomical location of the vessels, arising from the MFCA and supplying the FH. The IRA is in an elevated position from the femoral neck and may be protected from injury during fracture of the femoral neck. We present vascular 'danger zones' that may help avoid iatrogenic vascular injury during surgical interventions about the hip.
Hospital for Special Surgery, 535 East 70th street, New York, 10021, USA.
L E
LE
Lazaro
Hospital for Special Surgery, 535 East 70th street, New York, 10021, USA.
C E
CE
Klinger
Hospital for Special Surgery, 535 East 70th street, New York, 10021, USA.
P K
PK
Sculco
Hospital for Special Surgery, 535 East 70th street, New York, 10021, USA.
D L
DL
Helfet
Hospital for Special Surgery, 535 East 70th street, New York, 10021, USA.
D G
DG
Lorich
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D005263:Femoral Artery / Q000033:anatomy & histology*; D005270:Femur Head / Q000098:blood supply*; D005272:Femur Neck / Q000098:blood supply; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D013583:Synovial Membrane / Q000098:blood supply; D057772:Vascular System Injuries / Q000517:prevention & control
Retinacula of Weitbrecht; Retinacular Arteries; Terminal Branches; Vascularity