Superselective angiography of the wrist in patients with Kienböck's disease

BMC Musculoskelet Disord. 2019 Apr 4;20(1):143. doi: 10.1186/s12891-019-2492-5.

Abstract

Background: Microvascular problems like increased intraosseous pressure or venous congestion may influence the development of Kienböck's disease. We examined if wrist position modifies the blood flow in the nutrient vessels.

Methods: Retrospective analysis of 17 patients with Kienböck's disease who had a superselective microangiography of the radial, ulnar and interosseous artery in different wrist positions under general anaesthesia. We analysed the data with Fisher's exact and Wilcoxon-test.

Results: We found vessels that entered the bone, that ended at the bone edge, and that supplied a vascular plexus. The origins were the anterior interosseous artery in 10 of 17 cases, the radial artery in seven cases, and the ulnar artery in five cases. Movement of the wrist could reduce or stop the blood flow. Type of lunate configuration showed no significant influence on the blood supply in neutral position.

Conclusion: The radial, ulnar, and anterior interosseous artery contribute to the vascular supply of the lunate bone in different combinations. Wrist movement can reduce blood flow to the lunate bone.

Keywords: Kienböck’s disease; Lunate; Superselective microangiography.

MeSH terms

  • Adult
  • Angiography / methods*
  • Contrast Media / administration & dosage
  • Female
  • Humans
  • Lunate Bone / blood supply*
  • Lunate Bone / diagnostic imaging
  • Lunate Bone / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Osteonecrosis / pathology*
  • Radial Artery / diagnostic imaging*
  • Regional Blood Flow
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ulnar Artery / diagnostic imaging*
  • Wrist Joint / blood supply
  • Wrist Joint / diagnostic imaging
  • Young Adult

Substances

  • Contrast Media