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The Journal of Bone and Joint Surgery 78:1256-9 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Absence of Avascular Necrosis of the Humeral Head after Post-Traumatic Rupture of the Anterior and Posterior Humeral Circumflex Arteries. A Case Report*

CHRISTIAN GERBER, M.D.{dagger}, SIMON M. LAMBERT, M.D.{ddagger} and HENRI M. HOOGEWOUD, M.D.{ddagger}, FRIBOURG, SWITZERLAND

Investigation performed at the Departments of Orthopaedics and Radiology, Hôpital Cantonal, Fribourg


   Introduction
 
The vascularity of the proximal aspect of the humerus has recently been studied in detail2,6. The anterior humeral circumflex artery appears to be the main blood supply to the humeral head, while the posterior humeral circumflex artery has the most sizable anastomoses. The role of the intraosseous blood supply has been difficult to assess quantitatively, given the fact that no method has been developed to study the blood supply to the humeral head after complete obstruction of the major vessels. We recently examined a patient who had rupture of both circumflex arteries, as documented with angiography and operative observation, in association with a traumatic anterior dislocation of the shoulder. There was no evidence of avascular necrosis of the humeral head on radiographs or magnetic resonance images made eighteen months after the injury.


   Case Report
 
A fifty-seven-year-old man, who was right-hand dominant and had no history of problems related to the shoulder, . . . [Full Text of this Article]


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