Epiphyseal Arterial Network and Inferior Retinacular Artery Seem Critical to Femoral Head Perfusion in Adults With Femoral Neck Fractures

• DOI: 10.1007/s11999-017-5318-5
• Publication Date: 2017-03-17T15:10:14Z
• Authors: Dewei Zhao; Xing Qiu; Benjie Wang; Zihua Wang; Wei Wang; Jun Ouyang; Rona M. Silva; Xiaotian Shi; Kai Kang; Dachuan Xu; Chuang Li; Shizhen Zhong; Yu Zhang; Kent E. Pinkerton
• Keywords: Blood supply; Digital subtraction angiography

A better understanding of the blood supply femoral head is essential to guide therapeutic strategies for patients with neck fractures. However, because limitations conventional techniques, precise distribution and characteristics intraosseous arteries are not well displayed.To explore interconnections vessel system between different areas possible compensatory mechanism after fracture.The three-dimensional (3-D) structures in 30 uninjured normal human heads were reconstructed using angiography methods microCT scans. The data imported AMIRA® MIMICS® software programs reconstruct quantify extra- (diameter, length). In a separate experiment, we evaluated residual 27 fractures before surgery by analyzing digital subtraction data; during study period, this was performed on all whom hip-preserving planned, rather than arthroplasty. number affected unaffected subjects included three groups (superior, inferior, anterior retinacular arteries) types (Garden Types I-IV) recorded analyzed (Fisher's exact test) reflect degrees these fractures.The main results our cadaver were: (1) sources connected network as whole, epiphyseal arterial most widely distributed primary structure head; (2) stems which located periphery vascular have fewer anastomoses central region; (3) compared round ligament artery artery, inferior has relatively large caliber. Digital hip indicated that had high likelihood being fracture (100% [14 14] nondisplaced 60% [six 10] Garden Type III fractures).The appear be two important maintaining fracture. Increased efforts protect key surgery, such drilling placing internal implants closer region head, might helpful reduce effect iatrogenic injury system.3-D anatomic evidence frequency remained patent lead us consider necessity surgery. Future controlled studies evaluate proposition.