Medial Femoral Circumflex Artery - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the medial femoral circumflex artery. MFCA
The medial femoral circumflex artery is the primary source of blood supply to the femoral head. Damage to the MFCA due to trauma, fractures or surgeries may lead to avascular necrosis of the femoral head (AVN). The medial femoral circumflex artery arises from the posterior aspect of the profunda femoris artery. It then winds around the medial side of the femur, passing first between the iliopsoas and pectineus muscles. The medial femoral circumflex artery then passes between the obturator externus and the adductor brevis muscles to the back of the thigh. Posteriorly, the MFCA can be identified in the space between the quadratus femoris (superior edge of the quadratus femoris muscle) and the inferior gemellus. Quadriceps femoris muscle detachment from the femur during the posterior approach to the hip may cause profuse bleeding.
It divides into superficial, deep and acetabular branches. The branches of the MFCA have been named differently in the textbooks of anatomy. The extracapsular portion of the deep branch, is the portion of the MFCA most important to orthopedic surgeons as it can be damaged during the posterior approaches to the hip. The 5 consistent branches of the MFCA are:
•Superficial branch: courses between pectineus and adductor longus.
•Ascending: to adductor brevis, adductor magnus and obturator externus.
•Acetabular: gives off the foveolar artery (medial epiphyseal artery)
•Descending: courses between quadratus femoris and adductor magnus
•Deep: runs towards the intertrochanteric crest to the head of the femur. The deep branch runs towards the intertrochanteric crest between the pectineus medially and the iliopsoas tendon laterally along the inferior border of obturator externus. The deep branch of the MFCA crosses the tendon of obturator externus. As this branch travels superiorly, it crosses anterior to the conjoint tendon of gemellus inferior, obturator internus and gemellus superior. It then perforates the joint capsule at the level of gemellus superior and distal to the tendon of piriformis. This deep branch can be damaged during division of the short external rorattors in posterior approaches to the hip, interfering with perfusion of the hip. Short external rotators should be resected at least 1 cm away from their femoral attachment to avoid injury of the deep branch of the MFCA. The deep branch gives a constant branch “ trochanteric branch” at the upper border of the quadratus femoris going to the lateral aspect of the greater trochanter. This branch marks the level of the tendon of obturator externus.
The intra capsular segment of the deep branch of MFCA runs along the posterosuperior aspect of the neck of the femur then gives rise to 2-4 superior retinacular vessels and occasionally inferior retinacular vessels. The deep branch shares in the cruciate anastomosis with the lateral circumflex femoral artery. The deep branch also receives a direct supply from the inferior gluteal artery immediately before passing beneath the capsule of the hip. Precise knowledge of the extra capsular anatomy of the MFCA and its surrounding structures will help to avoid iatrogenic avascular necrosis of the head of femur reconstruction surgery of the hip and fixation of acetabular fractures through the posterior approach. Obturator externus protects the deep branch of MFCA from being disrupted or stretched during dislocation of the hip. Studies have shown that an intact obturator externus alone is important in protecting the MFCA even if all other muscular and capsular attachments of the femoral head and neck are cut.
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[@geojor]

crucial that the femoral head get a good blood supply, thank you Dr Ebraheim for bringing this to our attention...

[@sos7787]

Thank you

[@user-yj4zj3dh5z]

Very good

[@TheMollyEbraheim]

Great!

[@nabilebraheim]

thanks

[@phonekafanda]

very helpful video...thank u sir...plz upload videos of imp arteries,nerves,muscles n veins...

[@phonekafanda]

Ravi Patel this would be definitely helpful me in my pg entrance

[@user-xc7iq4ot7b]

عندى قصور فى الدورة الدموية لراس عظمة الفخد الايسر هل ليه علاج بدل عمليه

[@mehtapramod23]

good

[@nabilebraheim]

thanks

[@aymngndy1966]

😊😊

[@JFKHaircut]

circumflex circumflex circumflex

[@veronicachristopher-fellow5866]

What too complex