60 years female with fracture neck of left femur, develops vascular necrosis, which is most probably due to damage of
## **Core Concept**
The question tests knowledge of the blood supply to the femoral head and its relevance to avascular necrosis (vascular necrosis) following a femoral neck fracture. The femoral head receives its blood supply primarily from the medial and lateral circumflex femoral arteries, which give rise to the **retinacular arteries** that supply the femoral head.
## **Why the Correct Answer is Right**
The correct answer, **D. medial circumflex femoral artery**, is right because this artery is primarily responsible for supplying blood to the femoral head, especially after a fracture of the femoral neck. The medial circumflex femoral artery gives off the most significant number of retinacular arteries that run along the neck of the femur to supply the head. Damage to this artery during a femoral neck fracture can lead to avascular necrosis of the femoral head.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because while the **femoral artery** is a major artery in the thigh, it is not directly responsible for the blood supply to the femoral head. The femoral head's blood supply comes from branches of the femoral artery, not the artery itself.
- **Option B:** This option is incorrect because the **lateral circumflex femoral artery** does contribute to the blood supply of the femoral head but is less significant compared to the medial circumflex femoral artery in this context.
- **Option C:** This option is incorrect because the **profunda femoris artery** (also known as the deep artery of the thigh) is a parent artery that gives rise to both the medial and lateral circumflex femoral arteries but is not directly responsible for the damage leading to avascular necrosis.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that the blood supply to the femoral head is tenuous and can easily be compromised by fractures of the femoral neck. The medial circumflex femoral artery is particularly crucial, and its injury can lead to avascular necrosis, a common complication of femoral neck fractures.
## **Correct Answer: D. medial circumflex femoral artery**