ANATOMIC STUDY OF THE TENDINOUS ROTATOR CUFF OF THE SHOULDER

The aim of this study was a better understanding of the role of the va scular supply as a pathogenic factor in rotator cuff disease. Twenty-f ive 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 th e axillary a. the anterior circumflex humeral a., and the posterior ci rcumflex humeral a. The supraspinatus m. was supplied by the suprascap ular 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 circumfl ex humeral a. The tendon of the long head of the biceps brachii m. was supplied by a branch termed the ''arcuate artery'' [7] and by a branc h we describe derived from the brachial a. at the level of the latissi mus 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 tube rcle, situated mainly at the supraspinatus tendon. This is a convergen ce zone of the anterior and posterior circumflex humeral aa., the supr ahumeral a. [14] and the thoracoacromial a. The histologic studies con firmed the poor vascularity of this critical zone.