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Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett, Robert D. Acland, and G. Stephen Nettleton J Bone Joint Surg Am Volume 86(10):2135-2142 October 1, 2004 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

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Page 1: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective

by Matthew R. Price, Edward D. Tillett, Robert D. Acland, and G. Stephen Nettleton

J Bone Joint Surg AmVolume 86(10):2135-2142

October 1, 2004

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

View of a shoulder from above.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

Close-up view (oriented as in Fig. 1) of the glenoid fossa and the inferior portion of the shoulder capsule.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

Relevant portions of the inferior glenohumeral ligament (oriented as in Fig. 1).

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

The microdissection through the window cut in the inferior glenohumeral ligament reveals the axillary nerve branching as it traverses the quadrangular space.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

The axillary nerve (arrow), stained with Evans blue dye, before it enters the quadrangular space.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

The dotted line represents the location of the plane perpendicular to the surface of the glenoid fossa passing through the center-line (12 o'clock through 6 o'clock) position on the glenoid.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

The solid black lines represent the locations of serial coronal slices made through the glenoid fossa.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

Coronal slice through the glenoid fossa at the position 10 mm posterior to the first cut.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

Close-up view of Fig. 8.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

The typical branching pattern of the axillary nerve in relation to the shoulder joint capsule, as seen from a superior view, is depicted by the dotted lines.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Determining the Relationship of the Axillary Nerve to the Shoulder Joint Capsule from an Arthroscopic Perspective by Matthew R. Price, Edward D. Tillett,

The dotted line represents the course of the axillary nerve running inferior to the glenoid rim.

Matthew R. Price et al. J Bone Joint Surg Am 2004;86:2135-2142

©2004 by The Journal of Bone and Joint Surgery, Inc.