Vascular Anatomy of the Proximal Ulna

Purpose To describe the intraosseous arterial anatomy of the proximal ulna. Methods We used 9 fresh-frozen, above-elbow amputations to map the intraosseous arterial supply using the Spalteholtz technique. We treated 3 additional above-elbow amputations similarly, and then dissected them to map the extraosseous arterial supply. We recorded the extraosseous arterial patterns and compared them with the intraosseous arterial findings. Results The intraosseous arterial supply to the proximal ulna is derived primarily from a large nutrient vessel, a branch of the ulna artery, entering the anterior cortex of the ulna distal to the coronoid base, and from 2 medium-sized branches of the posterior and medial arcade entering near the olecranon tip. A watershed area is seen between these 2 vessel groups, halfway between the tips of the olecranon and coronoid. Conclusions The arterial supply of the proximal ulna is relatively consistent and flows in opposite directions from the 2 separate areas. Clinical relevance Knowledge of the arterial anatomy of the proximal ulna may assist the surgeon in minimizing surgical trauma, which may lead to improved healing after fracture fixations, osteotomies, and other surgical procedures around the elbow.