Arthroscopic posterior approaches to the wrist and periscaphoid vascular network: a cadaveric anatomical study.

The aim of our study was to assess the anatomical relationships between wrist arthroscopic portals and the periscaphoid vascular network. Fourteen fresh human cadaver wrists were perfused. Needles were placed in the 3–4, 6R, midcarpal radial (MCR), midcarpal radial scaphoid (MCRS), and scaphotrapezium-trapezoid (STT) portals. Contrast-enhanced CT scans were performed to analyze the constant arteries, their anatomical relationships, and their distance from the needles. Scaphoid vascularization mainly consisted of a dorsal branch along the dorsal ridge and a palmar branch opposite the waist. Our study highlights the probable and more frequent-than-expected presence of an anterior artery also located at the level of the waist. The STT portal showed the closest proximity to the dorsal branch of the scaphoid. The safe distances from this branch were smaller when using the STT portal compared to the MCRS portal. The dorsal arthroscopic portals commonly used to treat scaphoid nonunions carried a low risk of damaging these branches. The periscaphoid vascular network appears to be more complex and potentially more variable than classically described in the literature.