Anatomical considerations of subcoracoid neurovascular structures in anterior shoulder reconstruction

Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
James A TomNeil S Kumar

Abstract

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 fro...Continue Reading

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Citations

Nov 21, 2017·The Open Orthopaedics Journal·Bogdan A Matache, P Lapner

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