The anterior humeral circumflex artery (AHCA) and its venae comitantes, collectively called the “three sisters”, are commonly identified and ligated during a standard deltopectoral approach to the shoulder.
When viewed on an arteriogram, the posterior humeral circumflex artery (PHCA) appears larger than the AHCA. The PHCA is the dominant blood supply to the proximal humerus. The three sisters can usually be identified overlying the inferior aspect of the subscapularis tendon when the humerus is externally rotated. If they are not dissected and ligated, brisk bleeding can occur if they are inadvertently transected.
Review more high-yield concepts about the Shoulder Anterior (Deltopectoral) Approach on the most recent episode of The Orthobullets Podcast. Listen wherever you get your podcasts! https://anchor.fm/orthobullets/episodes/ApproachesShoulder-Anterior-Deltopectoral-Approach-ehe0dg/a-a2qq574
