Perforating Arteries of the Profunda Femoris

arteriae perforantes arteriae profundae femoris

The profunda femoris artery gives three to four perforating branches that pierce the adductor magnus muscle to reach the posterior thigh compartment and supply the posterior thigh muscles, the hamstrings, and the femoral shaft cortex. The first perforating artery contributes to the cruciate anastomosis of the hip. The nutrient artery to the femoral shaft typically arises from the second or third perforating branch.

Region: Thigh

Clinical Relevance

Clinical Notes

The perforating branches of the profunda femoris are encountered during the lateral approach to the femoral shaft for plating and during intramedullary nailing, where the perforators supplying the endosteum must be preserved by minimising periosteal stripping. In proximal femoral tumour resection, the profunda and its perforators may need to be ligated, requiring reconstruction or accepting collateral-dependent perfusion. The perforators are the pedicles for the profunda femoris artery perforator (PAP) flap used in breast reconstruction.

Pathology

Common Injuries & Conditions

Perforating Artery Haemorrhage in Femoral Shaft Plating

Perforating branches of the profunda femoris piercing the lateral intermuscular septum at multiple levels along the femoral shaft are at risk during the lateral approach for femoral plating; each perforator must be individually ligated or coagulated as it is encountered to prevent post-operative haematoma in the thigh.