Objective To observe the morphology and blood supply pattern of the trapezium bone and trapezoid bone, and provide reasonable anatomical basis for the clinical application. Methods Twelve wrist specimens were perfused with a mixture of lead oxide and gelatin powder into the main arteries of the wrist. After the perfusion, the Micro-CT scan was performed. The scanning data were imported into the software of Mimics for three-dimensional reconstruction. The morphology of the trapezium bone and trapezoid bone was observed, the number and location of the nutrient foramens were recorded, and the anastomosis and course of the blood vessels in the bone were analyzed. Results (1)The trapezium bone had a relatively constant number of nutrient foramen distributed on the three non-articular surfaces, which was (2.66±0.49) foramen on the radial side, (2.75±0.62) foramen on the dorsal side, and (2.33±0.65) foramen on the volar side, there were no statistical difference in the number of nutrient foramen among the three non-articular sides. The nourishing blood vessels branched out after penetrating into the bone and widely anastomosed with each other. About 70% of the blood supply in the bone came from the dorsal side, while 30% came from the volar and radial sides. (2) The trapezoid bone had a relatively constant number of nutrient foramen distributed on the two non-articular surfaces, (2.75±0.45) foramen on the dorsal side, and (2.42±0.51) foramen on the volar side, there were no statistical difference in the number of nutrient foramens between the two non-articular sides. The nourishing blood vessels branched out after penetrating into the bone, but its intraosseous blood vessel branch anastomosis was not as rich as that of the trapezium bone. About 70% of the blood supply in the bone came from the dorsal side, and 30% came from the volar side. Conclusions (1) The trapezium bone is rich in nourishing blood vessels from inside and outside the bone, which may be the reason why the incidence of the trapezium bone avascular necrosis is lower than other carpal bones. (2) The nourishing blood vessels outside the trapezoid bone are relatively abundant, but the intraosseous vascular anastomosis is not as rich as the large bone, this may be the main reason why the trapezoid bone are more prone to non-traumatic ischemic osteonecrosis than the trapezium bone.
Wang Yakang, Xu Yongqing, Yuan Libo, Zhang Xulin, Xu Yujian , Luo Haotian, Wei Mingjie
. Anatomical research on the morphology and blood supply of the trapezium bone and trapezoid bone[J]. Chinese Journal of Clinical Anatomy, 2021
, 39(2)
: 134
-139
.
DOI: 10.13418/j.issn.1001-165x.2021.02.004
[1] 许育健，何晓清，罗浩天,等. 三维重建Micro-CT扫描下月骨滋养血管的临床解剖学研究[J]. 中国临床解剖学杂志，2020，38(1):19-24. DOI:10.13418/j.issn.1001-165x.2020.01.005.
[2] 吴欢，徐永清，罗浩天, 等. 头状骨形态和血供的解剖学基础[J]. 中国临床解剖学杂志，2020，38(2):160-165. DOI:10.13418/j.issn.1001-165x.2020.02.012.
[3] 袁礼波，徐永清，张旭林, 等. 三角骨微结构的解剖学研究[J]. 中国临床解剖学杂志，2020，38(3):254-258. DOI:10.13418/j.issn.1001-165x.2020.03.004.
[4] 张旭林，徐永清，何晓清, 等.手舟骨骨内动脉的数字解剖学研究及其临床意义[J]. 中国临床解剖学杂志，2020，38(3):259-262. DOI:10.13418/j.issn.1001-165x.2020.03.005.
[5] 章莹, 尹庆水, 许家军, 等. 手舟骨微创内固定解剖学基础[J]. 中国临床解剖学杂志, 2004, 22(2): 176-178. DOI: CNKI:SUN:ZLJZ.0.2004-02-022.
[6] 覃励明, 徐永清. 头状骨、月骨、三角骨和钩骨的测量及意义[J]. 中国临床解剖学杂志, 2006, 24(2): 149-152. DOI: 10.3969/j.issn.1001-165X.2006.02.011.
[7] 楼新法, 梅劲, Christopher R. Geddes, 等. 明胶-氧化铅血管造影术的优化[J]. 中国临床解剖学杂志, 2006, 24(3): 259-262. DOI: 10.3969/j.issn.1001-165X.2006.03.010.
[8] Zafra M, Carpintero P, Cansino D. Osteonecrosis of the trapezium treated with a vascularized distal radius bone graft[J]. J Hand Surg Am, 2004, 29(6): 1098-1101. DOI: 10.1016/j.jhsa.2004.06.009.
[9]D'Agostino P, Townley WA, Roulot E. Bilateral avascular necrosis of the trapezoid[J]. J Hand Surg Am, 2011, 36(10): 1678-1680. DOI: 10.1016/j.jhsa.2011.07.022.
[10]曾立军, 徐永清, 骆华松, 等. 舟骨、大、小多角骨的临床解剖学研究[J]. 中国临床解剖学杂志, 2008, 26(1): 29-31. DOI:10.3969/j.issn.1001-165X.2008.01.007
[11]徐永清, 李川, 朱跃良, 等. 镍钛记忆合金舟大小融合器治疗Ⅲb期月骨无菌坏死的临床应用研究[J]. 中华手外科杂志, 2015, 31(2): 81-84. DOI: 10.3760/cma.j.issn.1005-054X.2015.02.001
[12]Baur EM. Arthroscopic-assisted partial wrist arthrodesis[J]. Hand Clin, 2017, 33(4): 735-753. DOI: 10.1016/j.hcl.2017.07.013.
