Vascular Bundle Implantation into Bone for Aseptic Necrosis of the Lunate

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Abstract
Since April 1986, implantation of a vascular bundle containing the ramus carpeus dorsalis of the interosseal anterior artery and vein into the lunate has been undertaken for aseptic necrosis of the lunate bone. A series of 11 cases were performed in East- South Hospital with satisfactory results. The average follow-up period was 36 months. A series of follow-up roentgenograms reveal that necrosis of the lunate bone is being continuously repaired. Fourteen months postoperative, the following results are obtained: (1) the sclerosis of the lunate bone has completely disappeared on the roentgenograms, (2) the architecture and density of the lunate bone have returned to normal on the roentgenograms, (3) technically colorized X-ray films show that lunate bone density decreases after the operation (the decreasing range is 20 to 44 Gray scale [mean, 30.3 ± 2.4 Gray scale]) and that the cyst formations on the lunate bone have completely disappeared postoperatively, and (4) pain in the affected wrists disappeared and patients have returned to their former work, including manual labor. The necrotized lunate bones are healed. Anatomic study shows that the presence of the ramus carpeus dorsalis of the interosseal anterior artery and vein on the wrist is 100%, and the structure as well as location of the ramus carpeus dorsalis has little anatomic variation and is long enough to be transplanted into the lunate bone.

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