Scaphoid Non-Union and AVN - Simon Richards 20/3/2001

BACKGROUND

Commonest carpal bone # (50-60%). Mainly men aged 15 - 30 yrs

Union rate is 90 - 95% . Intra-articular bone (almost completely covered in hyaline cartiladge)

Distal pole 30%, waist 60%, proximal pole 10%.

Scaphoid non-union = # that fails to show a progression of # healing on three separate monthly examinations after a treatment period of 6/12

Authors

Gelberman, Panagis et al

Title

The arterial anatomy of the human carpus. Part 1: The extraosseous Vascularity

Reference

The Journal of Hand Surgery. July 1983 Vol. 8, No. 4, 367 - 375

Summary

25 fresh cadavers. Arterial supply identified by injection of dye and subsequent chemical debridement. Most carpal bones receive blood from nutrient arteries Off 3 dorsal and 3 palmer transverse arches. The scaphoid receives it's supply from branches direct off the radial artey.

Critique

Impressive method of visualising these tiny structures. First detailed report of blood supply to carpus

Authors

Gelberman, Menon et al

Title

The Vascularity of the Scaphoid

Reference

The Journal of Hand Surgery. July 1980 Vol. 5, 508-513

Summary

25 fresh cadaversAs above. Found Scaphoid (and Capitate, 20% of Lunates ) to have large areas of the bone supplied by a single intraossous vessel. Therefore high AVN

Critique

Impressive method of visualising these tiny structures. First detailed report of blood supply to carpus



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