The Suprascapular Notch: Its Morphology Morphometry And Clinical Significance

Introduction: The Scapula is a large, flat, triangular bone which lies on the posterolateral aspect of the chestwall. The Suprascapular notch is a depression on the superior border of the scapula which gives passage toSuprascapular nerve. Anatomical variations of the shape and size of notch is useful as it is the common site ofSuprascapular nerve entrapment syndrome.Materials and Methods: The present study was carried out on 60 adult dry human Scapulae. Different shapes ofSuprascapular notch was observed, then vertical and transverse dimensions of the notch were measured.Results and Conclusion: Based on Rengachary classification, type III notch was found to be most common.Suprascapular foramen was observed in 5 Scapulae. The mean vertical and transverse diameters were measuredas 6.43mm and 9.81mm respectively. The study of morphology and morphometry of Suprascapular notch helpsto correlate Suprascapular nerve entrapment with specific type of notch.

Morphometric Study Of Suprascapular Notch In Dry Scapulae Bones

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.

Suprascapular Notch In Human Scapula: A Morphometric Study

Introduction: Suprascapular notch is a depression on the lateral one third of the superior border of the scapula.Suprascapular nerve passes through this notch. The shape of this suprascapular notch can vary among individuals.Various shapes and sizes of the notch and ossified superior transverse scapular ligament can compress thesuprascapular nerve leading to entrapment syndromes. Hence the study of morphometry of the notch is importantto diagnose and treat such entrapment syndromes.Materials and Methods: 58 dried human scapulas were used for the study. The morphology of the suprascapularnotch was studied. Presence and absence of the notch was observed. Type of notch was assessed based on the itsshape according to Rengachery’s classification. The superior transverse diameter, middle transverse diameter,maximum depth of the notch, and the distance between the posterior glenoid rim and the notch was measured.Results: Type II and type III notches are common in Indian population. Type II notch has larger diameters andgreater depth, while type IV has the least diameters and depth. Type V and VI notches are more prone forsuprascapular nerve entrapment due to ossification of superior transverse scapular ligament.Conclusion: Knowledge of different types of notches and its measurements are very helpful in diagnosis andmanagement of cases with shoulder pain due to suprascapular nerve entrapment and also while administeringsuprascapular nerve blocks for the surgeries involving the shoulder

Unusual morphology of scapulae: incidence and dimensions of ossified ligaments and supraspinous bony tunnels for clinical consideration

<p><b>INTRODUCTION</b>Knowledge of morphological variations of the suprascapular region is important in the management of entrapment neuropathy and interventional procedures. The objective of this study was to collect data on the morphological features and dimensions of ossified ligaments and unusual bony tunnels of scapulae from a North Indian population.</p><p><b>METHODS</b>A total of 268 adult human scapulae of unknown gender were obtained from the bone bank of the Department of Anatomy, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. The scapulae were evaluated for the incidence of ossified superior transverse scapular ligaments (STSLs), ossified inferior transverse scapular ligaments (ITSLs) and bony tunnels (i.e. the bony canal between the suprascapular notch and spinoglenoid notch), found along the course of the suprascapular nerve (SSN). The dimensions of these structures were measured and noted down. Ossified STSLs were classified based on their shape (i.e. fan- or band-shaped) and the dimensions of the ossified suprascapular openings (SSOs) were measured.</p><p><b>RESULTS</b>Ossified STSLs were present in 26 (9.7%) scapulae. Among the 26 scapulae, 16 (61.5%) were fan-shaped (mean area of SSO 16.6 mm(2)) and 10 (38.5%) were band-shaped (mean area of SSO 34.2 mm(2)). Bony tunnels were observed in 2 (0.75%) specimens, while an ossified ITSL was observed in 1 (0.37%) specimen.</p><p><b>CONCLUSION</b>The data obtained in the present study augments the reference literature for SSN decompression and the existing anatomical databases, especially those on Indian populations. This data is useful to clinicians, radiologists and orthopaedic surgeons.</p>

Variations of Suprascapular Notch in Adult Egyptian Scapulae.

Background: The suprascapular notch (SSN) lies on the superior border of scapula, close to the root of coracoid process. The suprascapular nerve passes through the notch, below superior transverse scapular ligament. The objective of the present study was to determine variations in the size and shape of SSN in adult Egyptian scapulae to provide a better diagnosis and management of suprascapular nerve entrapment syndrome. Material and methods: A total of 85 dry adult unpaired scapulae of unknown age and sex were randomly selected. The shape of SSN was determined by direct inspection and the vertical and transverse diameters of the notch were measured in each specimen. The results were recorded and statistically analyzed. Results: In the studied scapulae, the SSN was revealed in 89.41%, absent in 8.24% and replaced by a scapular foramen in 2.35% . Three morphological types of SSN were observed; U-shaped (60.53%), V-shaped (31.58 %) and J-shaped (7.89 %). The SSN had a longest transverse diameter (type II) in 55.26% and had a longest vertical diameter (type III) in 44.74%. The U-shaped variety was observed in 32.61% of type II and 67.39% of type III. All of J-shaped variety (100%) were exclusively observed in type II, whereas half (50%) of the V-shape variety were observed in type II and the other half (50%) in type III Conclusion: The diameters and morphological type of SSN documented in the present study might be easily identified on a plain radiograph that might be helpful in diagnosis of suprascapular nerve entrapment syndrome. Moreover, these anatomical data would improve the safety of arthroscopic nerve decompression.

The anterior coracoscapular ligament in Thais: Possible etiological factor of suprascapular nerve entrapment.

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.