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:
Nutrient Artery System:
Enters the diaphysis through the nutrient foramen.
Supplies the inner two-thirds of cortical bone and the medullary cavity.Periosteal Vessels:
Arise from surrounding soft tissues.
Supply the outer third of cortical bone, especially active during healing and in children.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.