Three-dimensional reconstruction of intraosseous vascularanatomy of the talus: a micro-computed tomography study

Abstract

Objective To acquire three-dimensional intraosseous artery of the talus in order to interpretthe prognosis of talus fractures. Methods Lower extremities of twelve fresh corpses were acquired. The femoralarteries in the femoral triangle were cannulated and manually perfused with lead-based contrast agent. Everyharvested talus was scanned using a microCT scanner (Inveon, Siemens Ltd., USA). The 3D high-accuracymodels of the talus were generated at 52.30 μm. The distribution and pattern of arteries in each section wereobtained and the intraosseous branches were counted. Results The numerous extraosseous arteries were mainly running in the articular capsules and ligaments around the talus. We identified four vascular zoneson the talus surface including tarsal canal-tarsal sinus, superior talus neck, medial talus body and posteriortubercle. A vessel ring around the talus neck was formed by the anastomosing of the extraosseous vessels inthe tarsal canal-tarsal sinus and on the superior talus neck (the number of intraosseous branches are 5.1±1.3and 5.6±1.9), which was the primary blood supply of the talus. The intraosseous branches of the ring weredistributed in the talus head, talus neck and most of the talus body with abundant anastomoses. Besides fromthe ring, the talus body also received intraosseous blood supply from medial talus body (3.2±1.4 intraosseousbranches) and posterior tubercle (0.7±0.5 intraosseous branches). Conclusion A severer destruction of theintraosseous branches of vascular ring resulting from talus neck fracture would pose a higher risk of talusavascular necrosis. As for talus body, the sagittal fracture and comminuted fracture caused relatively moredamage to the intraosseous branches of vascular ring, thus leading to an increased potential of avascularnecrosis. The osteonecrosis due to talar head fractures is rare because of the rich blood supply of talar head.

Keywords

• talus
• intraosseous vessels
• microct
• fractures