PURPOSE: Poor posture is strongly related to scapular kinematics and shoulder diseases. The purpose of this study was to clarify the blood flow changes of the anterior and posterior humeral circumflex arteries in reference to the scapular position and to clarify anatomical features related to the changes in blood flow. METHODS: Cadaveric shoulders were dissected to elucidate the anatomical difference between the two arteries. The blood flow of these arteries in healthy volunteers (22-48 years, 113 shoulders) was evaluated by MRI with changing the position of the scapula (internal and external rotation). RESULTS: The anterior humeral circumflex artery was attached to the subscapularis tendon and located beneath the subdeltoid bursa. The posterior humeral circumflex artery was located between the deltoid muscle and the bursa, which allowed free movement during scapular motion. There were no direct extraosseous anastomoses between the two arteries. Compared with the posterior humeral circumflex artery, the anterior humeral circumflex artery decreased blood flow with the scapula in internal rotation. CONCLUSIONS: No direct extraosseous anastomoses between the two arteries were observed. Internal rotation of the scapula decreased blood flow of the anterior humeral circumflex artery, which might be related to various pathologies of the shoulder. LEVEL OF EVIDENCE: Diagnostic studies, Level III.
PURPOSE: Poor posture is strongly related to scapular kinematics and shoulder diseases. The purpose of this study was to clarify the blood flow changes of the anterior and posterior humeral circumflex arteries in reference to the scapular position and to clarify anatomical features related to the changes in blood flow. METHODS: Cadaveric shoulders were dissected to elucidate the anatomical difference between the two arteries. The blood flow of these arteries in healthy volunteers (22-48 years, 113 shoulders) was evaluated by MRI with changing the position of the scapula (internal and external rotation). RESULTS: The anterior humeral circumflex artery was attached to the subscapularis tendon and located beneath the subdeltoid bursa. The posterior humeral circumflex artery was located between the deltoid muscle and the bursa, which allowed free movement during scapular motion. There were no direct extraosseous anastomoses between the two arteries. Compared with the posterior humeral circumflex artery, the anterior humeral circumflex artery decreased blood flow with the scapula in internal rotation. CONCLUSIONS: No direct extraosseous anastomoses between the two arteries were observed. Internal rotation of the scapula decreased blood flow of the anterior humeral circumflex artery, which might be related to various pathologies of the shoulder. LEVEL OF EVIDENCE: Diagnostic studies, Level III.
Authors: Y Hagiwara; A Ando; Y Onoda; T Takemura; T Minowa; N Hanagata; M Tsuchiya; T Watanabe; E Chimoto; H Suda; N Takahashi; H Sugaya; Y Saijo; E Itoi Journal: Osteoarthritis Cartilage Date: 2011-12-22 Impact factor: 6.576