Panagis J S, Gelberman R H, Taleisnik J, Baumgaertner M
J Hand Surg Am. 1983 Jul;8(4):375-82. doi: 10.1016/s0363-5023(83)80195-6.
The intraosseous vascular anatomy of the carpal bones of 25 fresh cadaver limbs was studied by injection and Spalteholz clearing techniques. The carpal bones were classified into three general groups based on the size and location of nutrient vessels, the presence or absence of intraosseous anastomoses, and the dependence of large areas of bone on a single intraosseous vessel. Group I included the scaphoid, capitate, and 20% of the lunates in this series. Each had large areas of bone dependent on a single intraosseous vessel and was considered at greater risk to develop avascular necrosis following fracture. Group II included the trapezoid and hamate, both of which have two areas of vessel entry but lack intraosseous anastomoses. Group III included the trapezium, triquetrum, pisiform, and 80% of the lunates in this series, which receive nutrient arteries through two nonarticular surfaces, have consistent intraosseous anastomoses, and have no large areas of bone dependent upon a single vessel. The clinical incidence of avascular necrosis in groups II and III is low.
采用注射法和施帕尔陶兹氏透明法对25个新鲜尸体上肢腕骨的骨内血管解剖结构进行了研究。根据滋养血管的大小和位置、骨内吻合支的有无以及大片骨对单一骨内血管的依赖程度，将腕骨分为三大类。在本研究系列中，第一类包括舟骨、头状骨和20%的月骨。每一块骨都有大片骨依赖单一骨内血管，被认为骨折后发生缺血性坏死的风险更高。第二类包括大多角骨和钩骨，二者均有两个血管进入区域，但缺乏骨内吻合支。第三类包括小多角骨、三角骨、豌豆骨以及本研究系列中的80%的月骨，它们通过两个非关节面接受滋养动脉，有一致的骨内吻合支，且没有大片骨依赖单一血管。第二类和第三类的缺血性坏死临床发生率较低。
