The distributed pattern of the neurovascular structures around clavicle to minimize structural injury in clinical field: anatomical study

Surg Radiol Anat. 2018 Nov;40(11):1261-1265. doi: 10.1007/s00276-018-2091-4. Epub 2018 Aug 27.

Abstract

Introduction: The aim of this study was to determine the location and distribution pattern of neurovascular structures superior and inferior to the clavicle by detailed dissection.

Methods: Fifteen adult non-embalmed cadavers with a mean age of 71.5 years were studied. For measurements, the most prominent point of the sternal end of the clavicle (SEC) on anterior view and the most prominent point of the acromial end of the clavicle (AEC) were identified and divided five equal sections before dissection. A line connecting the SEC and AEC was used as a reference line. The surrounding neurovascular structures were investigated.

Results: The supraclavicular nerve was mainly distributed in the second and the third sections (distribution frequency: 41.30% and 30.43%, respectively) from AEC. Branches of the thoracoacromial artery were mainly distributed in the second, third, and fourth sections (distribution frequency: 21.15%, 26.92%, and 28.85%, respectively). Branches of the subclavian vein were mainly distributed in the third and fourth sections (distribution frequency: 23.26 and 30.23%, respectively). Distribution frequency of subclavian vein, subclavian artery, and brachial plexus ranged from 31.3 to 57.5%.

Discussion: When the clavicle was divided into five sections, there was relatively little distribution of neurovascular damage in the first section or the fifth section. This study reveals the average location of subclavian vein with artery and brachial plexus. Results of this study could be used as reference during surgery.

Keywords: Anatomy; Clavicle fracture; Internal fixation; Subclavian vein; Supraclavicular nerve; Thoracoacromial artery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anatomic Landmarks
  • Cadaver
  • Clavicle / blood supply*
  • Clavicle / injuries
  • Clavicle / innervation*
  • Dissection
  • Fractures, Bone / surgery
  • Humans
  • Middle Aged