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There has been debate regarding medial or lateral retraction of the cephalic vein in the deltopectoral approach to the shoulder. Those who recommend lateral retraction of the vein cite multiple feeder vessels from the deltoid muscle; however, there is little evidence to support this in the orthopaedic literature. The purpose of our study was to determine if there are more lateral branches than medial branches to the cephalic vein in the deltopectoral groove. Forty fresh frozen cadaveric shoulders underwent retrograde latex injection of the cephalic vein. A deltopectoral incision was used, and the numbers of medial and lateral branches were recorded. In the deltopectoral groove there were more lateral than medial feeder vessels to the cephalic vein. There also were more branches to the vein in the proximal (1/2) of the incision compared with the distal (1/2). Most of the specimens dissected had more lateral branches to the cephalic vein than medial branches. Based on the number of feeder vessels to the cephalic vein, results of our study support lateral retraction of the cephalic vein in a majority of shoulders during the deltopectoral approach to the shoulder.

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