The Hip: Preservation, Replacement and Revision
Duke Orthopaedics
presents
Wheeless' Textbook of Orthopaedics

Blood Supply to the Wrist 



- See:
       - Arteries of the Upper Limb
       - Vascular Anatomy of Scaphoid
       - Vascularity of the Lunate

- Discussion:
    - vascular supply of wrist is obtained thru radial, ulnar, anterior interosseous arteries and the deep palmar arch;
    - extraosseous arterial pattern:
            - formed by anastomotic network of dorsal and palmar arches connected longitudinally at their medial & lateral borders by radial & ulnar artery;
    - palmar transverse arches include:
            - radiocarpal, intercarpal, & deep palmar arch;
    - palmar radiocarpal arch:
            - provides blood supply to palmar surface of lunate & triquetrium;
            - radial and ulnar recurrent arteries supply distal carpal row;

- Pathology of Vascular Supply to the Arch:
    - pathology of intrinsic blood supply to carpal bones is related to AVN following trauma;
    - scaphoid, capitate, and 20% of lunate are supplied by a single artery and are therefore are at risk for avascular necrosis;
    - trapezium, triquetrum, pisiform, & 80% of lunate receive nutrient arteries thru two non articular surfaces;
             - these bone have consistent intraosseous anastomosies & as might be expected, they rarely develop avascular necrosis;
    - trapezoid and hamate lack intraosseous anastomosis & following frx can have asvascular fragments



The blood supply of the human distal radioulnar joint and the microvasculature of its articular disk.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, December 12, 2012 4:19 pm

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