The arteries of the humerus and their relevance in fracture treatment

BACKGROUND: The purpose of the current work was to study the arterial blood supply of the humerus to evaluate impairments of the blood supply after humeral fractures and different methods of fracture treatment. METHODS: Arterial blood supply of the humerus was studied by corrosion injection technique in 6 cadaver preparations and is compared with the existing literature. RESULTS: Humeral head arteries originate from the circumflex humeral arteries. The major vessel enters the greater tubercle. Another group of vessels accesses the head from medially. The nutrient artery for the shaft enters into the medial third of the shaft. At the distal humerus there are multiple anastomoses with penetrating branches into both condyles and proximal to the radial, coronoid, and olecranon fossae. CONCLUSIONS: Fragments of a proximal humeral fracture usually have an independent blood supply. The medial vessels to the head gain high importance in fractures of the anatomical neck. The nutrient artery lies regularly medial to the humeral mid-shaft and is at risk at open reduction of this region. The abundant vessels at the entire distal humerus ensure sufficient vascularization of the fragments after fracture.