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月骨血供的研究及其在月骨无菌性坏死中的应用

Study of vascular supply of lunate and consideration applied to Kienböck disease.

作者信息

Dubey P P, Chauhan Navneet Kumar, Siddiqui M S, Verma Anoop K

机构信息

Department of Anatomy, Chhatrapati Shahuji Maharaj Medical University (U.P.), Lucknow (U.P.), India.

出版信息

Hand Surg. 2011;16(1):9-13. doi: 10.1142/S021881041100500X.

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.

摘要

本研究的目的是通过月骨的骨孔数量和腕部血管造影来评估月骨的血管情况。月骨软化症的发生需要一些血管方面的风险因素和机械性易患因素。研究结果与月骨无菌性坏死的病因相关。91.33%的月骨血管孔超过两个。月骨有来自桡动脉的恒定的背侧和掌侧分支。72.22%的病例中骨间前动脉的额外分支以及69.44%的病例中掌侧腕骨间弓的一个分支参与了月骨掌侧的动脉吻合。85.71%的标本中骨间前动脉为月骨提供背侧血供,50%的标本中背侧腕骨间弓的背侧分支为月骨提供血供。月骨的血供与各种韧带相伴,这些韧带可能因创伤或劳损而中断,导致缺血性坏死。与其他研究相比,目前的观察结果提示月骨血供丰富。因此,月骨无菌性坏死在印度北部较少见。

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