title: Anatomical basis of the vascular risk related to the circumflex scapular artery during posterior approach to the scapula.
abstract: OBJECTIVE
  The vasculature and anastomosis around the scapula is extremely intricate making surgical treatment complicated. We aimed to determine the "at risk area" for the circumflex scapular artery and its anastomosis with the suprascapular artery during posterior approach to the scapula.
  
  
  METHODS
  Sixteen shoulders from eight embalmed adult cadavers were dissected through posterior approach to the scapula to study the relationship of the circumflex scapular artery and its anastomosis with the suprascapular artery to bony landmarks of the posterior scapula. Three measurements were obtained: from inferior glenoid rim to the point of the bony groove of the circumflex scapular artery; from the posterior glenoid rim to the spinoglenoid notch; and from the spinoglenoid notch to the circumflex scapular artery.
  
  
  RESULTS
  The circumflex scapular was identified at a distance of 2.9 cm from the inferior glenoid rim and at a distance of 4.6 cm from the spinoglenoid notch, as it winds around the lateral border of the scapula to enter the infraspinous fossa. The suprascapular neurovascular bundle was identified at the spinoglenoid notch 1.8 cm from the posterior glenoid rim.
  
  
  CONCLUSIONS
  We were able to identify the relationship of the circumflex scapular artery to the anatomic landmarks of the scapula and to define the "at risk area" for the ascending branch of the circumflex scapular artery and its anastomosis with the suprascapular artery. We believe our anatomical study may aid in the avoidance of vascular complications during internal fixation of scapular fractures.
authors.affiliation: Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
authors.forename: Satheesh K
authors.initials: SK
authors.lastname: Ramineni
authors.forename: Sreenivasa R
authors.initials: SR
authors.lastname: Alla
authors.forename: Sneh
authors.initials: S
authors.lastname: Biyani
authors.forename: Richard A
authors.initials: RA
authors.lastname: Yeasting
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012540:Scapula / Q000098:blood supply* / Q000601:surgery
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