Intraosseous blood supply to the distal humerus.

Abstract

Nonunion of the distal humerus after fracture or osteotomy is uncommon but can present an important clinical problem. Vascular insufficiency of bone may be an important contributing factor. The purpose of this study was to describe the intraosseous vascular anatomy of the distal humerus. Nine fresh-frozen upper extremity cadaver specimens were injected with India ink and Ward's blue latex solution. A modified Spalteholz technique was used to show the intraosseous vascular anatomy. The distal humeral diaphysis was supplied by a single nutrient artery. The lateral column was supplied predominately by posterior segmental vessels, whereas the medial column was supplied by anterior and posterior segmental vessels. The trochlea, olecranon fossa, and coronoid fossa were watershed areas. Our study shows the intraosseous vascular anatomy of the distal humerus is relatively consistent. There also appears to be a consistent trochlear vessel medially and small anterior perforating vessels in the lateral column that have not previously been described.