Anatomical basis of the vascular risk related to the circumflex scapular artery during posterior approach to the scapula.
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.
Ebraheim
Nabil A
NA
Department of Orthopedic Surgery, University of Toledo Medical Center, Toledo, OH, USA.
Ramineni
Satheesh K
SK
Alla
Sreenivasa R
SR
Biyani
Sneh
S
Yeasting
Richard A
RA
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
J Am Acad Orthop Surg. 1995 Jan;3(1):22-33
10790650
Clin Orthop Relat Res. 1991 Aug;(269):174-80
1864036
Plast Reconstr Surg. 1981 May;67(5):631-6
7232584
Clin Orthop Relat Res. 2009 Aug;467(8):2011-7
19052826
Injury. 2008 Mar;39(3):271-83
17919636
Arch Orthop Trauma Surg. 1995;114(4):215-9
7662477
J Bone Joint Surg Br. 1984 Nov;66(5):725-31
6501369
Clin Orthop Relat Res. 1997 Jan;(334):136-43
9005906
Arthroscopy. 1990;6(4):301-5
2264898
Plast Reconstr Surg. 2004 Jun;113(7):2001-5
15253189
J Bone Joint Surg Am. 1993 Apr;75(4):479-84
8478375
J Shoulder Elbow Surg. 2001 Jul-Aug;10(4):372-6
11517368