[Vascularization of the pyramidal and pisiform bones]

Area of Science:

• Anatomy
• Vascular Surgery
• Orthopedics

Context:

• The pisiform bone's vascularization is crucial for its use in reconstructive surgery.
• Understanding the arterial supply of the distal ulna and carpal bones is essential for orthopedic procedures.

Purpose:

• To detail the arterial vascularization of the pisiform and triquetrum bones.
• To investigate the potential of the pisiform bone as a vascularized graft for lunatum (scaphoid) defects.

Summary:

• The dorsal branch of the ulnar artery vascularizes the medial pisiform and medial/dorsal triquetrum.
• A separate ulnar artery pedicle supplies the lateral pisiform, with constant deep and sub-capsular systems forming anastomotic networks.
• The pisiform, when transplanted with its vascular pedicle including the dorsal ulnar artery branch, can potentially replace the lunatum.

Impact:

• Provides detailed anatomical knowledge of wrist vascularity.
• Highlights the pisiform's potential as a vascularized graft in hand and wrist reconstruction.
• Informs surgical techniques for wrist injuries and deformities involving the lunatum and carpal bones.