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>

Reconstrucción de ligamento patelofemoral medial / Medial patelofemoral ligament reconstruction

Introducción: El Ligamento Patelo-Femoral Medial (LPFM) es el principal estabilizador estático de la traslación lateral rotuliana en los primeros 20º de flexión. La plástica del LPFM es un procedimiento utilizado para el tratamiento de la luxación recidivante de rótula. Objetivo: evaluar el resultado funcional y las complicaciones de la plástica aislada del LPFM, para el tratamiento de la luxación recidivante de rótula. Materiales y métodos: se pudieron evaluar 31 plásticas de LPFM en pacientes con luxación rotuliana recidivante. En 14 procedimiento se fijó el injerto con 2 arpones en la rótula (grupo I) y los 17 restantes se tunelizó la misma (grupo II). Los pacientes se evaluaron de forma retrospectiva con la escala de Kujala y se registraron las complicaciones. Resultados: en el grupo I se realizaron 2 movilizaciones articulares bajo anestesia por falta de flexión. Un paciente sufrio un episodio de luxación rotuliana. El puntaje promedio de la escala de Kujala fue de 90,5. En el grupo II hubo un caso de subluxación recidivante, otro caso de fractura de rótula, y se realizaron dos movilizaciones bajo anestesia por falta de flexión. El puntaje promedio de la escala de Kujala fue de 89,7. Conclusión: la plástica aislada del LPFM es un procedimiento reproducible y con buenos resultados en pacientes con luxación recidivante de rótula con distancia Troclea-TAT menor a 20 mm. Tipo de Estudio: Retrospectivo, comparativo, tipo serie de casos. Nivel de evidencia: III.

Background: Medial Patellofemoral Ligament (MPFL) is the primary static stabilizer to lateral patellar displacement in the first 20° of knee flexion. Reconstruction of the MPFL is used for treatment of patellofemoral instability. Objective: to evaluate the functional outcome and complications of isolated reconstruction of MPFL for treatment of recurrent patellar dislocation. Materials and methods: we were able to assess 31 reconstruction of MPFL in patients with recurrent patellar dislocation. In 14 cases graft was fixed using two suture anchors (group I) and the remaining 17 cases a transverse bony tunnel was performed (group II). Patients were evaluated retrospectively using the Kujala scale and complications were recorded. Results: in group I there were 2 joint mobilizations under anesthesia for lack of flexion. In one patient recurred patellar dislocation. The average score of Kujala scale was 90.5. In group II there was a case of recurrent subluxation, another case of patella fracture and there were two mobilizations under anesthesia for lack of flexion. The average score of Kujala scale was 89.7. Conclusion: Isolated reconstruction of MPFL is a reproducible procedure and with good results in patients with recurrent dislocation of patella trochlea-TAT distance less than 20 mm. Study Design: Retrospective, Comparative, Case series type. Level of evidence: III.