The blood supply of long bones comes from four systems: nutrient artery, metaphyseal, epiphyseal, and periosteal. The nutrient artery enters through the diaphysis and supplies the inner two-thirds of the cortex and medullary cavity. The periosteal system sends branches through the cortex. The epiphyseal system permits growth through openings into the ossification centers. The metaphyseal system reinforces the nutrient artery and anastomoses with epiphyseal vessels after growth stops. The growth plate itself is avascular and receives nutrients from epiphyseal and metaphyseal arteries. Venous drainage occurs through veins in the medullary cavity,