Microcirculation of the distal humeral epiphyseal cartilage: implications for post-traumatic growth deformities

The Journal of Hand Surgery
Z YangKen Yamaguchi

Abstract

The purpose of this study was to determine if there is an anatomic basis for development of the avascular necrosis infrequently seen after elbow trauma. The microcirculation to the distal humeral epiphyseal cartilage was studied in 38 elbow joints from 19 skeletally immature individuals. The findings of this study were as follows: (1) Vascularity is centripetal within the epiphyseal cartilages of the capitellum, trochlea, and medial and lateral epicondyles. Because of this vascularity pattern, it is not easy for avascular necrosis to develop after trauma within these epiphyses. (2) Vascularity is longitudinal in the epiphyseal cartilage between the capitellum and trochlea. The longitudinal vessels appear susceptible to fractures around the elbow in childhood. (3) A rich vascular network exists in the olecranon fat pad, and a vascular arch forms from the vascular network adjacent to the distal humeral epiphyseal cartilage. The vascular arch sends several large branches into the epiphyseal cartilage in a vertical fashion. Disruption of either the longitudinal intraosseous vasculature (vertical extraosseous blood supply) or the vascular arch in more than 2 places may lead to selective avascular necrosis of the epiphyseal cartilage...Continue Reading

References

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Citations

Oct 30, 2007·Archives of Orthopaedic and Trauma Surgery·Matthias HansenP M Rommens
Mar 1, 2006·Hand Clinics·Shawn W StormJohn D Lubahn
Dec 21, 2014·Pediatric Radiology·Srikala NarayananKatherine Nimkin
May 3, 2015·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·R GauthéJ Lechevallier
Jun 23, 2007·Journal of Pediatric Orthopedics·Corinne Elzy BronfenJean F Mallet
May 24, 2001·Journal of Pediatric Orthopedics·A K Vocke-HellP Stankovic
May 3, 2008·The Journal of Bone and Joint Surgery. American Volume·Reza OmidDavid L Skaggs
Mar 23, 2017·Journal of Pediatric Orthopedics. Part B·Gökçer UzerVolkan Gürkan
Dec 11, 2019·Journal of Pediatric Orthopedics. Part B·Lior ShabtaiJ Lee Pace
Oct 18, 2016·Journal of Pediatric Orthopedics. Part B·Hamlet A PetersonAnthony A Stans
Jul 1, 2011·Journal of Pediatric Orthopedics. Part B·Abdul Razak SulaimanEmil Fazliq Mohd
Apr 29, 2015·Journal of Pediatric Orthopedics. Part B·Junko OtsukaMasayuki Hiroishi
Jun 19, 2013·Journal of Pediatric Orthopedics·Michael P GlotzbeckerPeter M Waters
Oct 5, 2010·Clinics in Sports Medicine·R Michael GreiweChristopher S Ahmad

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