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Bone Circulation

Vascular anatomy of bone and its role in development, healing, and pathology.


Bone circulation is essential for skeletal development, remodeling, and repair. It involves three main vascular systems:

  1. Nutrient Artery System:
    Enters the diaphysis through the nutrient foramen.
    Supplies the inner two-thirds of cortical bone and the medullary cavity.

  2. Periosteal Vessels:
    Arise from surrounding soft tissues.
    Supply the outer third of cortical bone, especially active during healing and in children.

  3. Metaphyseal and Epiphyseal Vessels:
    Arise from adjacent arteries and supply the ends of long bones.
    These vessels are crucial for growth plate function and are susceptible to disruption in pediatric fractures.

Clinical relevance:

  • Avascular necrosis (AVN): Caused by disruption of bone blood supply, common in femoral head, scaphoid, and talus.

  • Fracture healing: Adequate vascular supply is necessary for callus formation and union.

  • Orthopaedic surgery: Careful preservation or restoration of blood flow is essential, especially in joint-preserving procedures and reconstructions.


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