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The Journal of Bone and Joint Surgery, Vol 72, Issue 10 1486-1494, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
The arterial vascularization of the humeral head. An anatomical study
C Gerber, AG Schneeberger and TS Vinh
Department of Orthopaedics, University of Bern, Inselspital, Switzerland.
In twenty-nine specimens from fresh cadavera, we performed an anatomical
study of the arteries of the humeral head to determine their intraosseous
distributions. A radiopaque suspension was injected into the anterior
circumflex, posterior circumflex, suprascapular, thoracoacromial, or
subscapular artery and then the specimens were dissected and were analyzed
macroscopically, and radiographs were made in three mutually perpendicular
projections. In addition, sixteen of the specimens were cut into
four-millimeter slices and were studied microradiographically. The humeral
head was shown to have been perfused by the anterolateral ascending branch
of the anterior circumflex artery in all specimens. That vessel ran
parallel to the lateral aspect of the tendon of the long head of the biceps
and entered the humeral head where the proximal end of the intertubercular
groove met the greater tuberosity. When the intraosseous (terminal) part of
the anterolateral branch, the so-called arcuate artery, had been perfused,
almost the entire epiphysis was radiopaque. The posterior circumflex artery
vascularized only the posterior portion of the greater tuberosity and a
small posteroinferior part of the head. Anastomoses between the different
arteries were abundant, but vascularization of all of the humeral head was
possible only through the anterolateral branch of the anterior circumflex
artery.
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