We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Arterial supply of the tendinous rotator cuff insertions: an anatomical study.
- Authors
Papakonstantinou, Maritsa K.; Pan, Wei-Ren; le Roux, Cara Michelle; Richardson, Martin D.
- Abstract
Background Confirming the presence of arteries crossing the osteotendinous junctions ( OTJs) of the rotator cuff may explain why rates of avascular necrosis ( AVN) of the humeral head vary between three- and four-part proximal humeral fractures. It is hypothesized that the humeral head remains better vascularized in three-part fractures because one tuberosity with its inserting rotator cuff tendons is still attached to the articular fragment and supplying it with blood. Methods Eighty rotator cuff tendons from 20 shoulder girdles of cadavers aged 68-94 years were studied. In six shoulder girdles, the anterior circumflex humeral artery and posterior circumflex humeral artery ( PCHA) were injected with ink, and the extra- and intraosseous courses of the vasculature were dissected until the OTJs of the rotator cuff. Results The rotator cuff insertions received an arterial supply across their OTJs in 50% of cases (75% in supraspinatus, 67% in subscapularis, 33% in infraspinatus and 20% in teres minor). Supraspinatus and subscapularis insertions were vascularized by the arcuate artery, while the insertions of infraspinatus and teres minor were supplied by an unnamed terminal branch of the PCHA. This was named 'posterolateral artery'. Conclusion The presence of arteries crossing the OTJs of the rotator cuff, as well as the differences in the frequency arteries crossed the OTJs of individual rotator cuff tendons, may help explain why there is a lower rate of AVN of the humeral head in thee-part, compared with four-part proximal humeral fractures.
- Subjects
ROTATOR cuff; IDIOPATHIC femoral necrosis; HUMERUS; ARTICULAR ligaments; INTRAOSSEOUS anesthesia; POSTEROLATERAL corner
- Publication
ANZ Journal of Surgery, 2012, Vol 82, Issue 12, p928
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/j.1445-2197.2012.06250.x