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Vascularity of the Lunate

- See:
       - Blood Supply to the Wrist
       - Kienbock's Disease

- Discussion:
    - majority of lunates have both dorsal & palmar vessels & are thus as well vascularized as the other carpal bones;
           - neither single intraosseous nor extraosseous disruption alone will cause avascular necrosis in these bones because of the rich external and internal anastomoses;
           - lunate blood supply may be jeparidized by dorsal approaches to wrist, but perfusion from palmar radiocarpal arch is adequate in most cases;
    - usually there is, an rich anastomotic network fed by multiple dorsal & palmar vessels;
    - in < 20% of pts: a single vessel enters palmar surface and branching with in the bone to provide the sole supply;
           - w/ this pattern, pts w/ in severe hyperextension injuries or dislocations may have a disruption of palmar nutrient vessels as they enter the bone