The relevance of the anatomical basis of fracture for the subsequent treatment of the anterior humeral circumflex artery and the axillary nerve

Purpose The purpose of this study was to determine the location of the anterior humeral circumflex artery and axillary nerve based on bony landmarks, and to provide anatomical information that enables a safe approach when treating a proximal humeral fractures. Methods Thirty cadavers were included. The distances of both the anterior humeral circumflex artery and the axillary nerve from body landmarks were measured using Vernier calipers. Results The mean distance between the inferior border of the medial acromion and the superior border of the anterior humeral circumflex artery was 5.1 ± 0.2 cm (range, 4.6–5.5 cm); the mean distance between the prominence of the lesser tuberosity and the superior border of the anterior humeral circumflex artery was 2.5 ± 0.2 cm (range, 2.0–3.0 cm); the mean distance between the anterior-inferior border of the acromion and the superior border of the axillary nerve was 6.3 ± 0.5 cm (range, 5.2–7.0 cm). Conclusions The artery is located approximately 5.1 cm below the inferior border of the medial acromion and 2.5 cm below the prominence of the lesser tuberosity, and the nerve was located approximately 6.3 cm below the anterio-inferior border of the acromion and 3.5 cm below the prominence of the greater tuberosity. The reduction manoeuvres should be conducted with extreme care in this region.