An investigation of the routes of venous drainage from the bone marrow of the human tibial diaphysis.

The routes of venous drainage from the diaphyseal marrow of the human tibia have been investigated by roentgenologic techniques following perfusion with an aqueous barium sulphate suspension. Plain roentgenographs immediately after perfusion revealed that the dye promptly escaped from the marrow into the general systemic circulation through a number of large transcortical routes. The periosteal veins were shown as a delicate network of venules lying on the external surface of the shaft. The perfused dye appeared diffusely scattered throughout the whole width of the medullary canal and extended from metaphysis to metaphysis suggesting the marrow to be an open circulatory system with ill-defined boundaries. A central venous sinus, as commonly perceived, was not demonstrated. Microradiographs revealed an extensive network of cortical sinusoids and venules that were continuous with similar vessels within the marrow and on the external surface of the bone. The injected dye also perfused the haversian venules. Intersinusoidal shunts, fine efferent vessels that did not combine to form larger venules, were observed within the marrow. The principal nutrient veins and their radicles were not demonstrated by this technique.