Summary
The operative exposure of a fracture in an osteosynthesis causes disturbances in the blood supply, which often leads to a prolonged process of healing or even to healing problems, a fracture non-union, which is frequently located at the forearm. In order to damage the supplying vessels as little as possible, the position, direction and penetration of the arteries of radius and ulna are demonstrated and systematised in this study. Near the elbow arteries, coming from large adjoining vessels, penetrate the area of the capsular insertion. The nutrient arteries enter both bones in the second proximal quarter of diaphysis, at the radius from anterior to medial, at the ulna from anterior to anteroradial. Small vessels, which penetrate closely proximal to the articular surface in order to supply the distal forearm bones, come from an anastomosis between the radial, the interosseous and the ulnar arteries. In this study access vessels, choice and position of implants will be discussed.
Résumé
L'abord d'un foyer de fracture en vue d'une ostéosynthèse perturbe la vascularisation artérielle des os, ce qui allonge la durée du processus de consolidation, cela peut même conduire à une pseudarthrose dont on connait la fréquence élevée au niveau de l'avantbras. Afin de limiter autant que possible les conséquences vasculaires de l'abord chirurgical, nous avons analysé et systématisé dans cette étude la position, la direction et les zones de pénétration des artères dans le radius et l'ulna. Au voisinage du coude les aa. nourricières des os provenant des vaisseaux voisins, pénètrent dans les os au niveau de la zone d'insertion capsulaire. Les aa. nourricières pénètrent les deux os de l'avant-bras au niveau du second quart proximal de la diaphyse; au niveau du radius cette pénétration se fait en avant et en dedans, au niveau de l'ulna en avant et en dehors. Les petits vaisseaux de la partie distale des deux os de l'avant-bras pénètrent juste en amont des surfaces articulaires et viennent d'une anastomose entre les aa. radiale, interosseuse et ulnaire. Dans cette étude l'abord des vaisseaux, le choix et la position des implants sont discutés.
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Giebel, G.D., Meyer, C., Koebke, J. et al. Arterial supply of forearm bones and its importance for the operative treatment of fractures. Surg Radiol Anat 19, 149–153 (1997). https://doi.org/10.1007/BF01627964
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DOI: https://doi.org/10.1007/BF01627964