The vascularity of the scaphoid bone

Area of Science:

• Orthopedic Surgery
• Anatomy
• Vascular Biology

Background:

• Scaphoid fractures are common.
• Avascular necrosis of the scaphoid is a significant complication.
• Understanding scaphoid vascularity is crucial for treatment.

Purpose of the Study:

• To investigate the extraosseous and intraosseous vascular supply of the carpal scaphoid.
• To elucidate the anatomical basis for scaphoid necrosis.
• To inform surgical approaches to minimize vascular damage.

Main Methods:

• Injection and clearing techniques were used.
• 15 fresh cadaver specimens were analyzed.
• Detailed examination of vascular pathways was performed.

Main Results:

• The radial artery is the primary blood source for the scaphoid.
• Dorsal branches of the radial artery supply 70-80% of intraosseous vascularity and the proximal pole.
• Volar radial artery branches supply 20-30% of the distal tuberosity region.
• The anterior interosseous artery provides excellent collateral circulation.

Conclusions:

• The vascular anatomy explains the predisposition to scaphoid necrosis, particularly in the proximal pole.
• The volar operative approach appears least traumatic to the proximal pole's blood supply.
• This study provides critical anatomical insights for managing scaphoid fractures and preventing complications.