The neurovascular anatomy is important to keep in mind. The arcuate artery which runs along the bicipital groove is a branch of the anterior humeral circumflex artery and a major contributor to the blood supply of the articular surface of the humeral head.

There are important vessels which come from the rotator cuff insertions and enter from the medial neck as well. Injury to the arcuate artery from the fracture or its manipulation is thought to cause AVN of the humeral head.

. . . from the Course Outline -

Blood Supply

• Anterior humeral circumflex artery, the anterior ascending branchwhich terminates as the
• Arcuate artery - enters the humeral head near the intertubercular sulcus
• Posterior humeral circumflex artery

Nerve Supply

• Axillary nerve
• Suprascapular nerve
• Musculocutaneous nerve