Summary
Background
A comprehensive understanding of the anatomy of the vascular supply of the coracoid
is needed to ensure that the coracoid remains vascularised in order to optimize bone
union during any coracoid transfer procedures. It is the purpose of this study to
present an anatomical overview of the blood supply of the coracoid process, describing
a previously unidentified vessel that arises directly from the axillary artery and
nourishes the coracoid process, permitting the coracoid to be used as a free bone
flap.
Methods
An anatomical study examining the blood supply to the coracoid process of the scapula
was performed in 14 shoulders from 7 fresh frozen (unembalmed) adult cadavers. In
addition, the vascular supply to the coracoid was studied in 22 shoulders in patients
during operations around the anterior shoulder.
Results
In all the cadaveric shoulders studied there was a single consistent direct branch
of the second part of the axillary artery that supplied the distal 2–3 cm of the coracoid
process with a corresponding vein. The mean pedicle length for the artery was 4.46 cm
(range 3.1–5.6 cm). This artery originated from the axillary artery from the antero-lateral
position in 6, lateral position in 3 and posterolateral position in 5 shoulders. The
mean pedicle length for the vein was 5.8 cm (range 4.5–7.8 cm). The vein joined directly
to the axillary vein in 3 shoulders and via another tributary (parallel to the axillary
vein) in 9 shoulders. The diameter of the artery and vein averaged 1–1.5 mm. The clinical
study confirmed the findings of the cadaveric study.
Conclusion
Our anatomical cadaveric and clinical studies demonstrate the presence of a previously
unidentified direct arterial branch from the second part of the axillary artery supplying
the anterior 2–3 cm of the coracoid process of the scapula. This consistent vessel
and accompanying vein should be preserved for any surgical procedure that involves
transfer of the coracoid process, such as the Laterjet and Bristow procedures for
shoulder dislocation and can be used for free transfer of the coracoid where a small
vascularised bone flap may be required.
Keywords
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Article info
Publication history
Published online: January 15, 2019
Accepted:
January 6,
2019
Received in revised form:
December 21,
2018
Received:
August 10,
2017
Identification
Copyright
Crown Copyright © 2019 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
