Anatomical study on the correlation between nourishing artery and lunate osteonecrosis

Objective To study the correlations between the nourishing artery and the ischemic necrosis of the lunate bone in order to provide evidence for better prevention and treatment of ischemic necrosis of the lunate bone. Methods Eight adult fresh upper limb specimens were infused with perchloroethylene added oxidized lead through brachial arteries. After 24-hour cold storage at 4℃, the distribution of the nourishing artery of the lunate bone was observed by CT scanning. The distribution and quantity of the vascular holes of the lunate bone were also observed. The relationship between the blood vessels of the lunate bone and the surrounding structures was observed, and the caliber of the vascular holes was measured. Results The blood supply of the lunate bone comes from the carpal palmar and dorsal artery network, and the palmar artery is the main source. The lunate bone and the surrounding carpal bones are mostly contacted with articular cartilage, lack of periosteum and tendon attachment, and their blood supply mainly relies on the nourishing vessels of the anterior carpal ligament. The average number of the palmar vascular holes was 2.13, the dorsal was 2.00, the medial area of the palmar lunate was 14, the lateral area of the palmar lunate was 3, and the dorsal lunate was 16. Conclusion The large and medium holes of the palmar lunate bone are more than those of the dorsal lunate bone which has more small holes. And the vascular holes of the palmar lunate bone are mostly distributed in medial area. The closer the bone fracture line is to the palmar pole, the higher the possibility of lunate ischemic necrosis is. The medial region of the palmar lunate bone should be avoided during open reduction and internal fixation for the lunate bone fractures. Key words: Osteonecrosis; Fracture fixation, internal; Nourishing artery of lunate bone; Vascular perfusion