Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Introduction: The angular artery is a branch of the thoracodorsal artery and is known to supply the inferior angle of the scapula. The scapula is an area of rich anastomoses that often have the potential to provide surgical applications for reconstructive surgeries. The lack of detailed anatomical research and clinical outcome studies hinders the ability to fully exploit the use of this artery and the scapula it supplies.
Materials and Methods: Seven sides (five on the left side and two on the right side) from six embalmed cadavers were harvested. The subscapular artery was identified supine with the arm extended. The thoracodorsal artery was then dissected to determine if the angular branch traveling into the inferior angle of the scapula. Branches of the angular artery were followed under the surgical microscope to ascertain where they supplied the bone. The distance from the inferior angle of the scapula to the osseous entry point of the angular artery was measured, and the average length was obtained. The scapulae were cut horizontally using a bone saw in four slices. the lateral border was harvested and embedded in paraffin, and A microtome was used to cut these samples into 5 µm slices, stained with Masson’s trichrome, and observed under a light microscope.
Results: The angular branch had a consistent course traveling inferiorly on the lateral border of the scapula on six sides out of seven. The vertical and horizontal mean distance from the inferior angle of the scapula to the osseous entry point was 32.7 mm (range from 22.5 to 46.9 mm) and 12.0 mm (range from 2.4 to 24.5 mm), respectively. In three specimens, the angular branch was found to have a clear continuation that supplied the inferior border. In one specimen, a branch wrapped around the lateral border of the scapula traveling toward its medial aspect.
Discussion: The present study has shown that the lateral border of the scapula can be thicker and have a richer blood supply than the medial border, which is supplied by the angular branch of the thoracodorsal artery. Based on our findings, the angular branch can be shorter and enter the lateral border instead of the inferior angle. The angular branch might reach the inferior angle in cases of a thick inferior-angle cortical bone. The robust blood supply ensures the viability of the grafted tissue, promoting healing and integration into the recipient site. Our results further provided additional anatomical evidence and showed the importance of the lateral border of the scapula, which receives ample blood.