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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.