Determe D, Rongières M, Kany J, Glasson J M, Bellumore Y, Mansat M, Becue J
Department of Traumatology and Orthopedic Surgery, CHU Toulouse Purpan, France.
Surg Radiol Anat. 1996;18(3):195-200. doi: 10.1007/BF02346127.
The aim of this study was a better understanding of the role of the vascular supply as a pathogenic factor in rotator cuff disease. Twenty-five shoulders from unembalmed cadavers were studied after injection of the upper limb aa. with barium sulfate. The predominant arteries were the vessels of the subscapularis m. These branches originated from the axillary a. the anterior circumflex humeral a., and the posterior circumflex humeral a. The supraspinatus m. was supplied by the suprascapular a. but the acromial branch of the thoracoacromial a. supplied the tendon of the supraspinatus. The infraspinatus and teres minor tendons were vascularised by the ascending branches of the posterior circumflex humeral a. The tendon of the long head of the biceps brachii m. was supplied by a branch termed the "arcuate artery" and by a branch we describe derived from the brachial a. at the level of the latissimus dorsi tendon and travelling in a true mesotendon. There is a very real critical zone, with a lesser blood-flow, 1.5 cm from greater tubercle, situated mainly at the supraspinatus tendon. This is a convergence zone of the anterior and posterior circumflex humeral aa., the suprahumeral a. and the thoracoacromial a. The histologic studies confirmed the poor vascularity of this critical zone.
本研究的目的是更好地了解血管供应作为肩袖疾病致病因素的作用。在向25具未防腐尸体的上肢动脉注射硫酸钡后，对其肩部进行了研究。主要动脉是肩胛下肌的血管。这些分支起源于腋动脉、旋肱前动脉和旋肱后动脉。冈上肌由肩胛上动脉供血，但胸肩峰动脉的肩峰支供应冈上肌腱。冈下肌和小圆肌腱由旋肱后动脉的升支供血。肱二头肌长头肌腱由一支称为“弓形动脉”的分支以及我们描述的一支在背阔肌腱水平源自肱动脉并在真正的腱系膜中走行的分支供血。在距大结节1.5厘米处有一个非常真实的关键区域，血流较少，主要位于冈上肌腱处。这是旋肱前、后动脉、肩峰上动脉和胸肩峰动脉的汇聚区域。组织学研究证实了这个关键区域血管供应较差。
