Inoue Jumpei, Tawada Kaneaki, Yamada Kunio, Takenaga Tetsuya, Tsuchiya Atsushi, Takeuchi Satoshi, Isobe Yuki, Hanaki Shunta, Murakami Hideki, Yoshida Masahito
Department of Orthopedic Surgery, Komaki City Hospital, Komaki, Japan.
Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan.
Orthop J Sports Med. 2024 May 8;12(5):23259671241248661. doi: 10.1177/23259671241248661. eCollection 2024 May.
There is a risk of cephalic vein injury during shoulder arthroscopy. However, limited data regarding its anatomic course are available.
To analyze the positional relationship and factors affecting the distance between the coracoid tip and cephalic veins.
Case series; Level of evidence, 4.
A total of 80 contrast-enhanced computed tomography images from 80 patients (mean age, 49.6 ± 20.3 years; 61 men) were retrospectively analyzed. The distance between the center of the coracoid tip and the vertical line through the cephalic vein was measured in the axial (D1) and sagittal (D2) planes. The distance between 1 cm lateral to the center of the coracoid tip and the vertical line through the cephalic vein was measured in the sagittal plane (D3). Each distance was compared according to patient sex and laterality. Associations between each distance and the patient's age, height, weight, and body mass index were investigated.
The mean D1 was 18.4 ± 7.3 mm in 59 patients. The mean D2 was 23.4 ± 11.6 mm, and it was within 10 mm in 10 patients (12.5%). The mean D3 was 33.7 ± 12.2 mm. There was no significant difference in D1, D2, and D3 according to patient sex or laterality. A positive correlation was observed only between D3 and patient height ( = 0.320; = .034).
The cephalic vein was found to travel a mean of 23.4 mm distal and 33.7 mm distal to 1 cm lateral to the coracoid tip. Therefore, Care should be taken to avoid cephalic vein injury when creating an anterior inferior portal or 5-o'clock portal around these areas.
肩关节镜检查期间存在头静脉损伤风险。然而，关于其解剖走行的可用数据有限。
分析喙突尖与头静脉之间的位置关系及影响两者间距的因素。
病例系列研究；证据等级，4级。
回顾性分析80例患者（平均年龄49.6±20.3岁；61例男性）的80张对比增强计算机断层扫描图像。在轴向平面（D1）和矢状平面（D2）测量喙突尖中心与通过头静脉的垂直线之间的距离。在矢状平面测量喙突尖中心外侧1 cm处与通过头静脉的垂直线之间的距离（D3）。根据患者性别和左右侧别比较每个距离。研究每个距离与患者年龄、身高、体重和体重指数之间的关联。
59例患者的平均D1为18.4±7.3 mm。平均D2为23.4±11.6 mm，10例患者（12.5%）的D2在10 mm以内。平均D3为33.7±12.2 mm。根据患者性别或左右侧别，D1、D2和D3无显著差异。仅观察到D3与患者身高呈正相关（r = 0.320；P = 0.034）。
发现头静脉在喙突尖远侧平均23.4 mm处以及在喙突尖外侧1 cm远侧平均33.7 mm处走行。因此，在这些区域周围创建前下入口或5点位置入口时应注意避免头静脉损伤。
