CIRCULAR ARTERIAL SUPPLY OF THE PISIFORM BONE

The arterial vascularization of the pisiform bone was studied from 15 cadavers to assess the possibility of pedicled pisiform transfer in Ki enbock's disease. The arterial vascularization of the pisiform bone co mes from three pedicles: an upper pedicle arising from the dorsal carp al artery, a lateral pedicle arising from the ulnar artery, and a lowe r pedicle arising from the deep palmar branch of the ulnar artery. The pisiform bone is well vascularized and, whatever the distribution of the pedicles within the bone itself, we always found an arterial circl e around it. The lengths of the upper and lower pedicles expressed as ratios of the length or width of the pisiform bone were variable, as i ndicated by the coefficient of variation that was greater than 36%. Th ere was no significant correlation between the length of the upper or lower pedicle and the length or width of the pisiform bone. The length of the upper pedicle, which was greater than the distance between the origin of the dorsal carpal artery and the center of the lunate, allo ws a pedicled pisiform transfer in Kienbock's disease. Nevertheless, i t is difficult to assert definitively that the upper pedicle is suffic ient to avoid a partial necrosis of the pedicled pisiform bone.