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- W4319161548 abstract "PURPOSE: This study sought to characterize the intraosseous and extraosseous arterial perfusion of the proximal phalanx using micro-computed tomography angiography (micro-CTA). METHODS: Eight cadaveric upper extremities were injected with a barium sulfate/gelatin suspension. Proximal phalanges were dissected and imaged at 30 µm per voxel using micro-CTA. Specimens were analyzed with a focus on osseous vascular anatomy and distribution. Endosteal and periosteal blood supply were characterized by length, anatomic course, and caliber. RESULTS: The base of the phalanx had a significantly greater number (8.0±3.5) of periosteal vessels than the shaft (4.1±1.6) and head (1.3±1.1, p<0.001) (Figures 1 and 2), with 34% (11/32) demonstrating an absence of periosteal vessels to the head. A nutrient endosteal vessel was noted in 100% of specimens. Entering at the junction of the middle and distal third of the bone, this nutrient vessel branched into proximal and distal extensions towards the diaphysis and phalangeal head respectively. The index finger nutrient vessel consistently entered P1 along its ulnar aspect (8/8 specimens). In the middle finger it more commonly entered the digit along its radial aspect (6 of 8) while the ring finger more commonly demonstrated an ulnar nutrient vessel (5 of 8). The small finger nutrient vessel was more often found along its radial aspect (7 of 8). CONCLUSION: Periosteal contributions to the perfusion of the proximal phalanx gradually diminish distally. The endosteal vascular anatomy is consistent, with a single diaphyseal nutrient vessel entering with reliable laterality on each digit. This vessel is often the only vessel supplying the head of the proximal phalanx, making this area particularly susceptible to vascular disruption. An understanding of the perfusion of the proximal phalanx can inform several pathologies as well as guide treatment and prognostication." @default.
- W4319161548 created "2023-02-04" @default.
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- W4319161548 date "2022-10-01" @default.
- W4319161548 modified "2023-09-26" @default.
- W4319161548 title "Illuminating the Proximal Phalanx: Revisiting Osseous Perfusion by Micro-computed Tomography" @default.
- W4319161548 doi "https://doi.org/10.1097/01.gox.0000898708.32678.e9" @default.
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