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Tracking the Anatomical Contents of the Quadrilateral Space: Clinical Implications
Author(s) -
Frumberg David Benjamin,
Beckman Michael Joseph,
Marquez Samuel
Publication year - 2009
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.23.1_supplement.822.3
Subject(s) - medicine , cadaver , anatomy , cadaveric spasm , pericardium , axillary nerve , surgery , brachial plexus
The quadrilateral space (QS), demarcated by osseo‐muscular borders, is the gateway for the axillary nerve (AN) and posterior circumflex humeral artery (PCHA) between anterior and posterior scapular regions. QS Syndrome is the condition whereby hypertrophy of associated musculature causes AN entrapment and compression of PCHA, potentially resulting in deltoid weakness, tenderness over the shoulder region, and pain radiating to the arm. This anatomical study assessed, identified, and categorized AN and PCHA transmission through the QS using a mixed‐sex sample size of 43 cadavers to determine the strength of association between AN and PCHA. Results showed AN present in all 86 QSs, while 89.5% contained PCHA. Variable arterial patterns observed were PCHA passing inferior to the teres major insertion on the humerus, originating from a common stem with the profunda brachii artery (9.3%) or from its own branch off the brachial artery (1.1%). One cadaver unilaterally possessed a PCHA in the QS and a branch from the profunda brachii artery. All unilateral arterial deviations occurred on the right side while two cadavers possessed bilateral deviations with PCHA arising from the profunda brachii artery. A full understanding of arterial variation in the QS region may help clinical characterization of QS Syndrome, and may obviate the need for arteriography to minimize postoperative bleeding and yield successful rehabilitation outcomes. Grant Funding Source DO NOT HAVE FUNDING