Blood supply of irregular bones — 2: Carpal and tarsal bones

Abstract

The nutrient vessels of the carpus and tarsus may be likened to the epiphyseal nutrients of tubular bones. These small masses of cancellous bone are covered with articular cartilages and limited areas of thin compact bone largely taken up by ligamentous attachments. Like long bone epiphyses, they are supplied by a number of small vessels rather than by a single major nutrient, the nutrient veins outnumbering the arterial vessels. For the talus and calcaneum, the sinus tarsi is an important site for the entry and exit of nutrient vessels (Haliburton et al. 1958; Montis & Ridola 1959a,b; Crock 1967). In their intra-osseous course, the arteries and venous sinuses radiate towards the articular surface where typical articular vascular plexuses are formed. When a growth cartilage is present in the calcaneum, typical subchondral circulations are found on each side of it, indistinguishable from those associated with the growth cartilages of long bones (Fig. 6.1). The predominantly venous character of the vessels in human tarsal bones has been noted by Vsevolodov (1959) and by Haliburton et al. (1958) in studies of preparations perfused with India ink, allowing the venous side of the circulation to be appreciated. In particular, these workers have shown innumerable capillaries and venules traversing the junctional region comprising the periosteum, cortex and cancellous bone in non-articular areas of the calcaneum and other tarsal bones.