Vascular anatomy of the distal radius: implications for vascularized bone grafts

The vascular anatomy of the distal radius and ulna is complex with a series of longitudinal vessels anastomosing with a series of arches. This complex anastomotic network of vessels has a consistent spatial relationship to surrounding anatomic structures and is constant in nature. Knowledge of the vascular anatomy of the distal radius and ulna has allowed the creation of numerous reverse flow pedicled vascularized bone grafts, which can be applied to carpal pathologic features to assist in the healing of difficult fractures or avascular necrosis. The anatomy and terminology of the vascular network and the implications, indications, and applications of this anatomy to carpal pathologic features is reviewed.