The acromial branch of the thoracoacromial artery passes laterally over the coracoid process and beneath the deltoid to the acromion, where it anastomoses with the suprascapular artery and the posterior circumflex humeral artery to form the acromial arterial network. It is the primary blood supply to the acromion and the acromioclavicular joint.
The acromial branch is at risk during acromioplasty and distal clavicle excision, where division of the vessel can compromise acromial vascularity and contribute to acromial stress fractures post-surgery. The acromial arterial anastomosis is the collateral pathway for subclavian artery occlusion proximal to the thoracoacromial origin. Doppler assessment of the acromial branch is used in planning local flaps for shoulder reconstruction.
Stress fracture of the acromion following acromioplasty with disruption of the acromial blood supply, presenting as shoulder pain and weakness weeks after surgery with a fracture line on plain film.
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