Aims: Despite the expansion of arthroscopic surgery of the shoulder, the open deltopectoral approach is increasingly used for the fixation of fractures and arthroplasty of the shoulder. The anatomy of the terminal branches of the posterior circumflex humeral artery (PCHA) has not been described before. We undertook an investigation to correct this omission.
Patients And Methods: The vascular anatomy encountered during 100 consecutive elective deltopectoral approaches was recorded, and the common variants of the terminal branches of the PCHA are described.
Results: In total, 92 patients (92%) had a terminal branch that crossed the space between the deltoid and the proximal humerus and which was therefore vulnerable to tearing or avulsion during the insertion of the blade of a retractor during the deltopectoral approach to the shoulder. In 75 patients (75%) there was a single vessel, in 16 (16%) a double vessel and in one a triple vessel.
Conclusion: The relationship of these vessels to the landmark of the tendon of the insertion of pectoralis major into the proximal humerus is described. Damage to these previously undocumented branches can cause persistent bleeding leading to prolonged surgery and post-operative haematoma and infection, as well as poor visualisation during the procedure. Cite this article: Bone Joint J 2016;98-B:1395-8.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1302/0301-620X.98B10.38011 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A comparative study of the minimally invasive lateral shoulder approach and deltopectoral space approach for the treatment of proximal humerus fractures.
BMC Surg
January 2025
Department of Orthopedics, General Hospital of Southern Theater Command of PLA, Guangzhou, 510000, People's Republic of China.
Objective: To compare the clinical efficacy of the minimally invasive lateral shoulder approach and deltopectoral space approach in the treatment of proximal humerus fractures.
Methods: The clinical data of 95 patients with proximal humerus fractures admitted to the hospital from June 2018 to June 2023 were retrospectively collected. Forty-four patients were treated with a minimally invasive lateral shoulder approach (study group), and 51 patients were treated with a deltopectoral space approach (control group).
Background Proximal humerus fractures (PHFs) are often injuries that occur in the field of orthopedics and can either be treated conservatively or operatively. The PHILOS (Proximal Humerus Interlocking System) and the proximal humerus nail (PHN) are the commonly used operative techniques. Objectives The objective of this study is to analyse the functional outcome of the PHILOS (Proximal Humerus Internal Locking System) and the PHN (Proximal Humerus Nail) in proximal humerus fractures.
View Article and Find Full Text PDFLatissimus Dorsi Tendon Transfer and Reverse Shoulder Arthroplasty: Restoring Mechanical Advantage by Transfer Posterior to the Long Head of the Triceps Tendon.
J Shoulder Elbow Surg
December 2024
Shoulder and Elbow Division, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.
View Article and Find Full Text PDFCorrelation of Radiological Parameters with Functional Outcomes in Proximal Humeral Fractures Treated with PHILOS Plates: A Retrospective Analysis.
J Orthop Case Rep
December 2024
Department of Orthopaedics and Traumatology, Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India.
Introduction: Proximal humerus fractures are prevalent, especially among the elderly, and pose significant challenges in treatment, particularly for displaced fractures. Despite the availability of various surgical techniques, outcomes remain inconsistent, often due to poor anatomical reduction and fixation. This study examines the correlation between specific radiographic parameters and functional outcomes, aiming to identify key predictors of recovery.
View Article and Find Full Text PDFImplant Mismatch does not Affect Patient Outcomes in Primary Reverse Shoulder Arthroplasty.
J Shoulder Elbow Surg
December 2024
Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Rue J.-D. Maillard 3, 1217 Meyrin, Switzerland; Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva; University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland; FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Avenue J.-D. Maillard 3, 1217 Meyrin, Switzerland. Electronic address:
Background: There is a paucity of literature on manufacturer mismatch in reverse shoulder arthroplasty (RSA). It is unclear if use of different implant manufacturers for the glenoid side and the humeral side influences patient outcomes in primary RSA. We hypothesize that patients undergoing primary RSA with manufacturer mismatch such that humeral and glenoid components are from different manufacturers will not experience adverse outcomes when compared to a cohort of patients with humeral and glenoid components from the same manufacturer.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!