The arterial blood supply of the distal radius and ulna and its potential use in vascularized pedicled bone grafts

We investigated the extra- and intraosseous blood supply of the distal radius and ulna (descriptive anatomy) and defined potential vascularized pedicled bone grafts to the carpal bones (applied anatomy). We studied 41 cadaver upper limbs using several techniques including angiography, Batson's compound and latex injections, and bone clearing using a modified Spalteholtz technique. Several known arteries were described in greater detail, and numerous previously undescribed arteries were found and investigated. Vascularized pedicled grafts have potential applicability for carpal pathology. Several grafts have been described from the radius, second metacarpal, and pisiform. We have identified several vascular pedicles that provide the hand surgeon with additional options. Some of these grafts provide a wider arc of rotation, greater ease of harvest and/or improved vascularity compared to many previously described grafts.