Logo image
Back
Anatomical considerations of subcoracoid neurovascular structures in anterior shoulder reconstruction
Journal article   Peer reviewed

Anatomical considerations of subcoracoid neurovascular structures in anterior shoulder reconstruction

James A Tom, Douglas L Cerynik, C Marcus Lee, Gabriel E Lewullis, Neil S Kumar and Sarah S Long
Clinical anatomy (New York, N.Y.), v 23(7), pp 815-820
Oct 2010
DOI: https://doi.org/10.1002/ca.21025
PMID: 20641067
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Aged Aged, 80 and over Axillary Artery - anatomy & histology Brachial Plexus - anatomy & histology Female Humans Male Middle Aged Shoulder Joint - surgery
Anterior shoulder surgery, using open or arthroscopic technique, places subcoracoid neurovasculature at risk. This study examines the relationships of the brachial plexus and axillary artery to four bony landmarks and provides clinical correlations for anterior shoulder surgery. The musculocutaneous nerve (MN), posterior cord (PC), lateral cord (LC), and axillary artery (AA) were identified in 27 shoulders. Minimum distances (mm) were measured between neurovasculature and the coracoid tip, anterior midglenoid, inferior surface of the midclavicle, and anteromedial aspect of the acromioclavicular joint. Average distances from the coracoid to the MN, PC, LC, and AA were 69.7 ± 31.6, 50.5 ± 9.2, 41.8 ± 9.4, and 60.0 ± 8.0 mm, respectively; from the glenoid equator to the MN, PC, LC, and AA were 61.5 ± 38.5, 37.0 ± 6.1, 35.2 ± 8.7, and 45.2 ± 7.1 mm, respectively; from the midclavicle to the MN, PC, LC, and AA were 114.1 ± 33.9, 62.0 ± 13.6, 56.0 ± 19.7, and 69.9 ± 7.8 mm, respectively; and from the AC joint to the MN, PC, LC, and AA were 112.7 ± 36.5, 87.9 ± 10.6, 84.0 ± 12.0, and 100.9 ± 1.0 mm, respectively. The lateral cord was the closest structure to each bony landmark. The musculocutaneous nerve was the furthest structure from each bony landmark. Open procedures using a deltopectoral approach with the shoulder in the anatomical position, such as the Neer capsular shift and Warner capsular reconstruction, can use these results to prevent direct or retraction injuries. Results indicate a potential safe zone of 30 mm in diameter around the anteromedial coracoid tip for anteroinferior portal placement.

Metrics

9 Record Views
2 citations in Web of Science
4 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#5 Gender Equality

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Web of Science research areas
Anatomy & Morphology
Logo image