ABSTRACT
Introduction: The superior transverse scapular ligament (STSL) is present above the suprascapular notch . It joins the two superior corners of this notch and converts it into suprascapular foramen through which passes the suprascapular nerve , while the suprascapular artery and vein usually pass above the ligament . The anterior coracoscapular ligament (ACSL) runs in the suprascapular notch, below the superior transverse scapular ligament. Narrowed bony foramen by ossification of STSL and ACSL is one of the predisposing factor of suprascapular nerve entrapment as well as with an injury to the suprascapular nerve in arthroscopic procedures. Aim: The aim of present study was to know the prevalence of suprascapular foramen in Indian dry scapulae and provide a knowledge on the variations along the course of suprascapular nerve which is essential to understanding the source of entrapment syndrome. Methods and Results: The present study was carried out on 73 dried human scapulae irrespective of age and sex. Visual observation revealed that 3 scapulae (4.1%) had completely ossified superior transverse scapular ligament and 2 scapulae (2.7 %) had partially ossified STSL. The incidence of ossified anterior coracoscapular ligament is 1.3 % ( 1 scapula ) in our study. Conclusion: The knowledge of variations in the suprascapular region and ossification of STSL & ACSL is important for anatomists, orthopaedicians, radiologists and neurosurgeons to obtain a safe zone which would be useful to avoid iatrogenic nerve lesion and for better diagnosis and management of the nerve entrapment syndrome.
ABSTRACT
Objective: To study the incidence of anterior coracoscapular ligament in Thais as well as morphology of the ligament. Materials and methods: One hundred and twenty seven scapulae from 64 Thais embalmed cadavers were used to scrutinize the presence of the anterior coracoscapular ligament. Relation between the ligament and the suprescapular nerve was also observed. The incidence, morphological feature and dimension of the anterior coracoscapular ligament were recorded. Simultaneously, the photos were taken. Sample of the ligament was randomly collected to process under standard histological technique for microscopic study. Results: The anterior coracoscapular ligament was found in 19 cadavers (28%), 4 cases (6%) were bilateral and 15 (22%) cases were unilateral. The ligament was a fibrous band located inferior to the superior transverse scapular ligament. The ligament attached proximally to anteromedial surface of the root of coracoid process, fibers descended to anterior surface of the scapular in the vicinity of the suprascapular notch. According to its distal attachment, the anterior coracoscapular ligament was divided into 3 types. Furthermore the dimension of the ligament as well as its microscopic feature was also elaborated. Conclusion: The existence of the anterior coracoscapular ligament caused the reduction in the height or narrowed the suprascapular foramen; together with the configuration of suprascapular notch may be one of the predisposing causes of suprascapular nerve entrapment.