Study of Vascular Supply of Lunate and Consideration Applied to Kienböck Disease

Abstract

The purpose of this study was to assess vascularity of the lunate by number of foramina and radiography of vessels of the wrist. The genesis of lunatomalacia requires some vascular risk and mechanical predisposition. The findings were correlated with the cause of Kienböck's disease. The vascular foramina were more than two in 91.33% of the lunate. The lunate had consistent dorsal and palmar branches from radial artery. The additional branches from anterior interosseous artery in 72.22% and a branch of palmar inter carpal arch in 69.44% cases contributed in arterial anastomosis on palmar aspect of lunate. The dorsal blood supply was found by anterior interosseous artery in 85.71% of specimens and dorsal branch from dorsal intercarpal arch in 50% of specimens. The blood supply of lunate comes along with various ligaments which may be disrupted due to trauma or strain leading to avascular necrosis. The present observations are suggestive of rich blood supply of lunate in comparison of other investigations. Therefore Kienböck's disease is less common in northern India.

Radiological Investigation of Relationship Between Lunate type and Ulnar Variance

“…Despite the lack of statistically significant difference in occurrence of any of the lunate type with individual ulnar variances, in half of the cases negative lunate variance co-occurred along with second type of the lunate. These are patients who need to be given special attention because "theoretically" they may be more prone to contracting the disease (3,7,9). CONCLUSIONS 1.…”

Treatment of Aseptic Necrosis of the Lunate Bone (Kienböck Disease) Using a Nickel–Titanium Memory Alloy Arthrodesis Concentrator

“…Kienböck disease is caused by blood supply disruption and concentrated stress of the lunate bone. 10 This disease is best treated with different strategies according to the disease stage. 11 Kienböck disease of stage I is managed using plaster fixation.…”

Kienbock’s disease, Avascular Necrosis of Lunate: A Clinico-anatomical Insight

“…The palmar supply got contribution from anterior interoseous artery in 72.2% and a branch from palmar intercarpal arch in 69.44% of the cases. The dorsal supply came from anterior interosseous branch in 85.71% and dorsal branch form dorsal intercarpal arch in 50% of specimens [7] . The dorsal and volar arterial systems anastomose distal to the mid line of the bone, thus the proximal part being less vascular and more prone to post traumatic avascular necrosis [8].…”