Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/578
Title: Arterial supply of the tendinous rotator cuff insertions: an anatomical study.
Epworth Authors: Richardson, Martin
Other Authors: Papakonstantinou, Maritsa
Pan, Wei-Ren
le Roux, Cara
Keywords: Avascular Necrosis of Bone
Necrosis, Avascular, of Bone
AVN
Arterial Supply
Posterolateral Artery
PCHA
Rotator Cuff
Cuff, Rotator
Shoulder Fractures
Three-Part Proximal Humeral Fractures
Four-Part Proximal Humeral Fractures
OTJ
Osteotendinous Junctions
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Dec-2012
Publisher: Wiley Online Library
Citation: Australian and New Zealand Journal of Surgery. 2012 Dec;82(12):928-34.
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.
URI: http://hdl.handle.net/11434/578
DOI: 10.1111/j.1445-2197.2012.06250.x
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/22984792
ISSN: 1445-2197
Journal Title: Australian and New Zealand Journal of Surgery
Type: Journal Article
Affiliated Organisations: Taylor Lab, Department of Anatomy and Neurosciences, The University of Melbourne, Parkville, Victoria, Australia.
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Musculoskeletal

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