The vascularity of the lunate bone and Kienböck's disease

J Hand Surg Am · 1980 · Classic · cited 272 times

Richard H. Gelberman, Thomas D. Bauman, Jaysanker Menon, Wayne H. Akeson

Hand & Upper Extremity

SUMMARY — THE REDUCTIONA cadaver injection study of 35 wrists mapped lunate blood supply, finding rich dorsal and volar vessels with consistent intraosseous anastomoses, supporting repeated-trauma compression fracture as the likely cause of Kienböck's disease.
Abstract, as published

The extraosseous and intraosseous vascularity of the lunate was studied in 35 fresh cadaver limbs. The specimens were injected with latex, debrided by a nondissection technique, and cleared by a modified Spalteholtz method. The extraosseous vascularity was profuse through two to three dorsal and three to four volar vessels feeding dorsal and volar capsular plexuses. One ot two nutrient vessels were observed entering the dorsal and volar poles of the lunate from both plexuses. The intraosseous vascularity formed one of three consistent patterns with anastomoses of dorsal and volar vessels in each specimen. The vascular patterns support a theory of compression fracture from repeated trauma as the most likely cause of Kienböck's disease.

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