- 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