ABSTRACT
Background:The suprascapular notch is a depression in the lateral part of superior border of scapula. The suprascapular ligament bridges the notch. Thesuprascapular nerve passes below the ligament and corresponding artery above the ligament. Variation in size and shape of suprascapular notch is identified as one of the causes of suprascapular nerve entrapment.Aim Of Study:To study morphological variations of suprascapular notch in dry scapulae of South Gujarat (Indian) population and compare data with studies in other ethnic populations. Materials And Methods:Total 200 dry human scapulae were obtained from Anatomy departments of three medical collegesof south Gujarat. Three dimensions were defined and measured for each suprascapular notch (SSN) using classical osteometry: maximal depth (MD), superior transverse diameter (STD) and middle transverse diameter (MTD). Based on Micha? Polguj’s classification SSN was classified into five types. The results of the present study were compared with previous studies in different populations.Results:The proportion of Type III SSN is highest (46.5 %) followed by Type V (26 %), Type I (16 %), Type IV (6 %) and Type II (5.5 %). For Type III SSN, proportion of subtype III c is highest (36.5 %), followed by subtype III b (6 %) and subtype III a (4 %). For Type I SSN, proportion of subtype I c is highest (8.5 %), followed by subtype I a (4 %) and Subtype I b (3.5 %).Conclusion:The suprascapular nerve entrapment syndrome, in most cases is due to morphological variations of suprascapular notch particularly complete ossification of suprascapular ligament. So the knowledge of such variations is essential for clinicians,to make a proper diagnosis of shoulder pain and to plan the most suitable surgical intervention.
ABSTRACT
Introduction: The suprascapular notch is present on the superior border of the scapula, just medial to thecoracoid process. The suprascapular ligament bridges the edges of notch, which sometimes get ossified andconvert suprascapular notch into foramen.A narrow notch or excess ossified ligament may have a greaterchance of a nerve impingement in the suprascapular foramen.Materials and methods: This study was conducted on the bones that were obtained from the bone bank ofDepartment of Anatomy. A total of 118 (57 right, 61 left) human scapulae derived from adult (35 male and 17female) skeletons were evaluated for the shape of suprascapular notch ,presence of any ossification of thesuprascapular ligament and classified according to Rengachary et al into I –VI types.Results: On analysis of morphological variations of suprascapular notch, we found following types of scapulae:Type I -22.42 %, Type II -12.98 %, Type III -53.98 %, Type IV -0 %, Type V- 7.08 %, Type VI -3.54%.. Out of all specimens,in three specimen suprascapular ligaments (3.54 %) were found to be completely ossifiedConclusion: The knowledge of morphometric variations of suprascapular notch and ossification of suprascapularligament is very important for clinicians. This knowledge is very important in sports medicine as well as fororthopaedic surgeons in management of cases of shoulder pain.
ABSTRACT
Background: Suprascapular nerve most commonly compressed at the level of suprascapular notch (SSN) andspinoglenoid notch. Variation in morphological features of SSN and spinoglenoid notch plays a crucial role insuprascapular nerve entrapment syndrome.Objective: Present study was conducted to find out the variation in morphology and dimension of SSN and todetermine posterior safe zone for shoulder joint procedures from posterior approach.Materials and Methods: In the present study 83 dry scapulae of south Karnataka region were studied andclassified the SSN based on various shapes according to Iqbal et al and measurements according to Natis et al,along with this, the mean distance from SSN to supraglenoid tubercle and mean distance between posterior rimof glenoid cavity and medial wall of spinoglenoid notch at the base of scapular spine were also measured .Result: Based on Iqbal et al classification ‘U’ shaped notch found to be more common (43.37%) and ‘V’ shapednotch and indentation found to be least common(3.6%). Complete ossification were observed in 3 scapulaebone(3.6%). Based on Natsis classification most common was found to be type –II (TD>VL) (84%) and type VI andIV were not observed. Mean distance between SSN and supraglenoid tubercle was 31.08 mm and mean distancebetween posterior rim of glenoid cavity and medial wall of spinoglenoid notch at base of scapular spine was14.26mm.Conclusion: Since variation in morphologoy of suprascapular notch and ossification of superior transversesuprascapular ligament(STSL) can be a factor for suprascapular nerve entrapment syndrome and safe zone fordifferent population varies. Hence knowing variations in shape and size of SSN, safe zone for different populationis helpful. So this study may be useful for clinicians for better diagnosis and management. Still more populationspecific studies are required related to the morphology of suprascapular notch.