[Extrinsic and intrinsic vascularization of the scaphoid and lunate bones]

This work was performed on 50 wrist dissections. The scaphoid is situated in the territory of the radial artery. Two extracapsular vascular pedicles are constant: --the lateral pedicle arises in the anatomical snuff-box, --the anterior pedicle arises in the "wrist pulse" area and passes behind the flexor carpi radialis. It lies on the radio-carpal ligaments. THe intra-capsular pedicles approach the scaphoid from its proximal pole. There are anastomoses and they lie on the deep dorsal and palmar ligaments. The multiple anastomotic branches may form an inconstant pedicle. The lunate is supplied by frequent but inconstant arterial pedicles. They are palmar and dorsal, superficial and deep (intra-capsular), distal and proximal, and lie on the radiocarpal ligaments. They originate from the three principal arteries of the hand or their branches. Anastomotic connections exist between them; if the vascular arrangement is complete, it is very reliable; when it is incomplete, it predisposes to Kienböck's disease. There is a close functional relationship between the scaphoid and the lunate. The vulnerability of these two bones to trauma which can also affect their ligaments explains the relative frequency of ischemic complications.