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Study of the vascular architecture of bones using the plastination technique

Using a different plastination technique for the tridimensional study of bone and surrounding structures, on the one hand, and reconstruction of threedimensional analysis of different segments, on the other hand, it is possible to study extraand intraosseous vascular distributions. In the last few years, articles clearly describing this process have been published (Moody and Lozanoff, 1998; Andermahr et al., 2001; Sha et al., 2001; Qiu et al., 2003, 2004; Sora et al., 2004; 2007; Li et al., 2006; Soal et al., 2010). We read with interest the article ‘‘Presentation of the microscopic vascular architecture of the radial head using a sequential plastination technique" by Koslowsky et al. (2011), published in Clinical Anatomy. We would like to congratulate Koslowsky et al. for presenting data on the morphological parameters of the extraand intraosseous blood supply to the radial head, with direct clinical relevance to surgical treatment of the radial head. This article, together with the article by Rath et al. (2009), provides a new perspective regarding the analysis and distribution of the vascular pattern in bones and surrounding structures. In the section that presented the results of the study, the authors described, with maximum clarity, four essential aspects: the extraosseous blood supply of the radial head, the intraosseous blood supply of the radial head, the functional adaptation of the pericervical vascular anatomy during forearm rotation, and the interaction of standard implants with the periand interosseous blood supply. The vascular anatomy of the proximal radius is based on the presence of the pericervical arterial plexus. Mainly, two arteries create the pericervical arterial plexus: the recurrent radial artery that supplies the ventral, lateral, and dorsal parts, and a branch of the ulnar artery (ramus periostalis ulnaris) that supplies the medial and dorsomedial parts of the radial head. These two main vessels create an anastomosis on the dorsal side of the radial neck via a subchondral plexus. This anastomosis is interrupted on the ventral side of the radial head. In addition, a third source of blood supply to the radial head comes out from the ulnar artery as branches of an interosseous artery. The radial recurrent artery is the main intraosseous source of blood. The authors described the presence and components of an infrachondral arterial plexus around the radial head. Special attention was given to the description of the intraosseous blood supply of the radial head and to interaction of standard implants with the periand interosseous blood supply. We would like to add to the author’s presentation two distinct problems: first, the age group of the study material and, second, the technique for achieving the plastination preparation.