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The clinical anatomy of the clavicle with emphasis on the vascular supply and associated pathologies
Author(s) -
Hanisch Jesse,
Bean Alex,
Richards Alan T,
Norton Neil S
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a442-c
Subject(s) - clavicle , sternoclavicular joint , medicine , anatomy , dissection (medical) , scapula , rib cage , subclavian artery , shoulder girdle , sternum , surgery
The clavicle is the first bone in the body to ossify. It is the only bone of the appendicular skeleton that articulates with the axial skeleton. This anatomical position permits it to be exposed to various pathological conditions such as trauma. In this study, we sought to examine the vascular supply of the clavicle placing special emphasis on the related pathologies that occur. Bilateral dissection of 13 cadavers (n=26) was performed on the clavicle. It was observed that the vascular supply of the clavicle consisted of a series of regions each with their own vascular pedicle. In the sternoclavicular region, the internal thoracic artery provided articular branches to both the sternoclavicular joint and the medial segment of the clavicle. The suprascapular artery supplied the majority of the clavicle. Arising in the posterior triangle, it would supply the superior aspect of the clavicle lateral to the sternoclavicular joint. The thoracoacromial artery would parallel the suprascapular artery in distribution, but arising in the axilla, it supplied the inferior portion. Thus, any compromise of these blood vessels may lead to a significant demise of segments of the clavicle. Head and neck oncologic surgeons are well aware of the effects of radiation exposure during therapy. During radiation therapy in the sternoclavicular region scarring and necrosis of the tissues, specifically the supraclavicular artery, may result in tissue decomposition which often will not recover. While not frequent, osteonecrosis of the medial end of the clavicle may result, and leads to functional impairment of the individual.