THE NORMAL VASCULAR ANATOMY OF THE HUMAN FEMORAL HEAD DURING GROWTH

Have copy. Also free on net. Method: 46 Cadaveric femora from male and females western european patients form birth to late adolescence (but only 1 in 6-9 yr age group). Spateholtz transparency technique with Prusion blue injection and histo or barium (micropaque) and micropradiographs.

Results No gender differences upt ot 14.

5 PHASES OF BLOOD SUPPLY

1) BIRTH - Vessels penetrating lateral head/neck running horizontally -Vessels from the ossified metaphysis/shaft (mainly medial) crossing line of future capital physis - small and inconstant supply from ligamentum teres.

2)INFANTILE (4mo-4yr) -Metaphyseal vessels crossing region of furture physis (mainly) -Lateral epiphyseal vessels -None from ligamentum teres (all atrophied)

3)Intermediate (4- 7 years) -Lateral epiphyseal vessels only -Growth plate becoming established and metaphyseal vessels disappear -no contribution from lig teres yet. -tight grouping of vessels in lat head

4)Preadolecent (9-10) --Lateral vessel + lig teres

Lig teres vessel now penetrate the ossific nucleus an anastamose with the "far awa" lateral epiphyseal vessels

5)Adolescent Physis begings to breack down (close) and metaphyseal vessels cross again. Blood from 3 sources again possible lat epiphyseal, metaphyseal and lig teres.

From the conclusion of the paper: " 1. The results of a study of the characteristics of the vessels found in forty-six human femoral heads during the growth period are described. 2. Of the three different sources of blood entering the human adult femoral head it was found that from birth to about three to four years the vessels of the ligamentum teres do not contribute to the nourishment of the head. 3. After the fourth year the metaphysial vessels decrease in importance until they finally disappear, leaving the head with only one source of blood through the lateral epiphysial vessels; the ligamentum teres is not yet contributing to the circulation of the head. 4. After about eight or nine years it was found that the vessels of the ligamentum teres contribute to the blood supply of the head while the metaphysial blood flow is still arrested. 5. Finally, at puberty, after a period of activity of the metaphysial vessels, epiphysial fusion takes place, bringing together the three sources of blood characteristic of the adult. This work would have been impossible without the help received from a number of workers who assisted me