title: Safety zone for surgical access in the middle third of the clavicle: study on cadavers.
abstract: OBJECTIVE
  The aim of this study was to establish a neurovascular safety zone for surgical access in the middle third of the clavicle, by means of dissection on cadavers.
  
  
  METHODS
  Twenty shoulders were dissected in 10 cadavers, with deep dissection of the middle third of the clavicle. The following structures were identified: subclavian vein, upper trunk of the brachial plexus (anterior and posterior divisions) and suprascapular nerve. These structures were marked out in order to measure their distances from the most proximal point of the middle third of the clavicle.
  
  
  RESULTS
  The mean distances from the middle third of the clavicle to the suprascapular nerve, subclavian vein, upper trunk, anterior division of the upper trunk and posterior division of the upper trunk were respectively, for the right side: 15.92 cm, 10.77 cm, 23.68 cm, 14.60 cm and 15.42 cm; and for the left side: 12.69 cm; 9.82 cm; 22.19 cm; 12.16 cm and 13.46 cm.
  
  
  CONCLUSIONS
  There was a statistical difference in the distances to the suprascapular nerve and anterior division of the upper trunk, in comparing between the right and left sides. The closest neurovascular structures to the middle third of the clavicle were the suprascapular nerve and subclavian vein.
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fabiano Rebouças
authors.initials: FR
authors.lastname: Ribeiro
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: de Marchi Bosi Porto
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcio Vieira Sanches
authors.initials: MV
authors.lastname: Silva
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Tenor Junior
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors.forename: Miguel Pereira
authors.initials: MP
authors.lastname: da Costa
authors.affiliation: Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil.
authors.forename: Cantidio
authors.initials: C
authors.lastname: Filardi
keywords: Cadaver; Clavicle/anatomy; Clavicle/surgery