Dorsal Distal Radius Pedicled Vascularized Bone Grafting for Avascular Necrosis of the Carpus

Although avascular necrosis can occur in any of the carpal bones, they more commonly affect the scaphoid (Preiser disease) and the lunate (Kienbock disease). Many revascularization options have been described, mostly pedicled vascularized bone grafts from the volar and dorsal aspect of the distal radius and carpus. Pedicled vascularized bone grafts from the dorsal distal radius is rooted on a consistent and rich arterial network that allows for many different donor sites based on the location of the recipient carpal bone. In the treatment of Preiser disease and Kienbock disease, we prefer to use the 1,2-intercompartmental supraretinacular artery and the 4th+5th extensor compartment artery pedicled dorsal distal radius bone grafts.