Seeley Mark Alan, Georgiadis Andrew G, Sankar Wudbhav N
From the Department of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA (Dr. Seeley), the Department of Orthopaedic Surgery, Gillette Children's Specialty Healthcare, St. Paul, MN (Dr. Georgiadis), and the Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA (Dr. Sankar).
J Am Acad Orthop Surg. 2016 Aug;24(8):515-26. doi: 10.5435/JAAOS-D-15-00237.
Throughout development, the vascular supply to the proximal femur and acetabulum undergoes a series of changes during which it is susceptible to injury. Before age 3 months, the ligamentum teres and lateral epiphyseal arteries are the dominant supply to the developing head. The dominant supply shifts to the lateral epiphyseal vessels by age 18 months. The distinct metaphyseal and epiphyseal circulations of the adult proximal femur form in adolescence when an increasingly rich metaphyseal circulation supplies the subphyseal region, terminating at the physeal plate. The acetabular blood supply derives from two independent systems, with the dominance of each changing throughout maturity. Most descriptions of the vascular contributions to the proximal femur and acetabulum have been gross anatomic and histologic studies. Advanced imaging studies (eg, CT angiography, perfusion MRI) have added to our understanding of the vascular anatomy of the proximal femur and acetabulum, its changes throughout development, and its clinical implications.
在整个发育过程中，股骨近端和髋臼的血管供应会经历一系列变化，在此期间它易受损伤。在3个月龄之前，圆韧带和外侧骨骺动脉是发育中的股骨头的主要供血来源。到18个月龄时，主要供血转移至外侧骨骺血管。成人股骨近端独特的干骺端和骨骺循环在青春期形成，此时日益丰富的干骺端循环供应骨骺下区域，并在骨骺板处终止。髋臼的血液供应来自两个独立的系统，每个系统的优势在整个成熟过程中都会发生变化。大多数关于股骨近端和髋臼血管贡献的描述都是大体解剖学和组织学研究。先进的影像学研究（如CT血管造影、灌注MRI）增加了我们对股骨近端和髋臼血管解剖结构、其在整个发育过程中的变化及其临床意义的理解。
