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An anatomic study of the cephalic vein in the deltopectoral shoulder approach

Christopher A Radkowski1, Richard S Richards, Ricardo Pietrobon

  • 1Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.

Clinical Orthopaedics and Related Research
|January 6, 2006
PubMed

Insights

This study found more lateral feeder vessels to the cephalic vein in the deltopectoral groove. Results support lateral retraction of the cephalic vein during shoulder surgery.

Area of Science:

  • Orthopaedic Surgery
  • Anatomy

Background:

  • The deltopectoral approach to the shoulder involves retraction of the cephalic vein.
  • Debate exists regarding whether to retract the cephalic vein medially or laterally.

Purpose of the Study:

  • To determine if more lateral than medial feeder vessels supply the cephalic vein within the deltopectoral groove.
  • To provide evidence to inform the optimal retraction strategy for the cephalic vein.

Main Methods:

  • Forty fresh frozen cadaveric shoulders were utilized.
  • The cephalic vein was injected retrogradely with latex.
  • A deltopectoral incision was made, and medial and lateral branches were counted.

Main Results:

  • A greater number of lateral feeder vessels to the cephalic vein were observed compared to medial vessels.
  • More branches were noted in the proximal half of the deltopectoral incision than the distal half.
  • The majority of specimens exhibited more lateral than medial branches.

Conclusions:

  • The findings support lateral retraction of the cephalic vein in most shoulders during the deltopectoral approach.
  • This evidence suggests a preferred surgical technique based on vascular anatomy.

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