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Introduction: Morphometric study of spinoglenoid notch, coracoacromial arch, and another measurement of the scapulae are required to understand the reason for spasms of common muscle due to supraspinatus tendinitis, nerve compression over the spinoglenoid notch. Therefore, the aim of this study was to discuss the subcoracoacromial arch, deviation of the spinous process, and measurement of the spinoglenoid notch. Materials and Methods: This study was conducted at the Department of Anatomy, Sri Venkateshwaraa Medical College Hospital & Research Centre, Chennai, Tamil Nadu, India on 70 scapulae that include 58 non-articulated scapulae and 12 articulated scapulae. All the measurements were performed with a vernier caliper and the alignment of the spinous process of the scapula was measured with a goniometer. All the measurements are compared on both sides. Results: All the measurements were performed and presented as mean with standard deviation. We found the variation of diameter between the left and right sides. Spinoglenoid notch diameters were noted as anterior to posterior right 2.97 ± 0.37 cm, left 3.06 ± 0.56 cm and medial to lateral right 1.36 ± 0.14 cm, left 1.4 ± 0.08 cm. Subcoracoacromial arch was observed as right 1.85 ± 0.23 cm and left 1.92 ± 0.4 cm. The direction of the spinous process of the scapula was noted as right 21.50º ± 8.50 and left 18.8º ± 7.89. Conclusion: The present morphometric study findings may give a different approach to supraspinatous tendinits, shoulder instability, and dislocation cases due to morphometric changes present in the spinous process, acromion process, glenoid cavity, and spinoglenoid notch of the scapula. These morphometric studies on scapula can help radiologists, orthopedicians, and physiotherapists to plan patient management.
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Background: The coracoacromial ligament (CAL) as an integral component of the coracoacromial arch, plays animportant role in shoulder biomechanics, joint stability, and proprioception thus maintains static restraint dueto its dynamic interactions with ligaments, muscles and bony elements around the shoulder joint. Age-dependentchanges due to chronic stress and cellular degradation cause thickening and stiffening of the CAL that maycontribute to a spectrum of shoulder pathology from capsular tightness to rotator cuff tear arthropathy andimpingement syndrome.Objectives: This study conducted to observe the different types of CAL and its relationship with coracoacromialveil.Materials and Methods: The study conducted on 50 upper limbs at Bowring & Lady Curzon medical college &research institute and Bangalore medical college & research institute. The upper limbs were dissected at theshoulder joint complex and acromion process and coracoid process were appreciated and coracoacromialligaments were appreciated for their types and morphometry.Results and Conclusion: Four types of CAL were observed in this study. These are Y shaped CAL in 12 (24%) upperlimbs, broad banded in 8 (16%), quadrangular band shaped in 25 (50%) and multiple banded in 5(10
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Introduction: The coraco-acromial ligament forms coraco-acromial arch along with acromion and coracoidprocess of scapula which prevent the superior humeral head displacement. It plays a key role in the pathoetiology of sub-acromial impingement syndrome when there are no significant bony abnormalities.Material and Methods: In the present study we have studied 120 formalin preserved upper limbs (right: 60; left:60) of unknown age and sex. Each shoulder was dissected carefully to see coraco-acromial ligament. The CALwas identified with careful blunt dissection to prevent overlooking any thinner bands. We observed the numberof bands present and shape of the ligament. Photographs were taken.Results: Different morphological subtypes of coraco-acromial ligament were observed and classified accordingto Kesmezacar et al. Type II (28.33 %) was the most common then type I (25 %), type IV (17.5 %), type V (15 %), typeIII (11.66%). Anterolateral band of ligament extended antero-laterally to form coracoacromial falx in 51%.Discussion: Coraco-acromial ligament shows different morphological variations in Indian population. Knowledgeof morphological variations of coraco-acromial ligament will be helpful for orthopedic surgeon for clinical andintraoperative decision while dealing with sub-acromial impingement syndrome.
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Objective To study the effects on anterosuperior stability of the shoulder joint when the coracoacromial arch is damaged at different degrees. Methods Thirty-six specimens of the fresh frozen adult shoulder joints were randomly and evenly divided into 3 groups. Group 1, reserving integrity of the coracoacromial ligament of the shoulder joint; Group 2, dissecting half of the coracoacromial ligament attachment sector on the acromion; Group 3, grinding all the coracoacromial ligament attachment sector on the acromion. The specimens of the shoulder joint were fixed on test bench of the biomechanical testing machine. The axial pressure was applied on the humeral shaft, and the humeral head was pushed to move in anterosuperior direction. The displacement distance of the humeral head under 50 N pressure was then recorded. Results Under 50 N pressure, the displacement distance of the humeral head in Group 1, 2, 3 was (2.50±0.59), (5.38±0.71), (6.49±0.81) mm, respectively, which showed significantly statistic differences among 3 groups (P<0.05). Conclusions The damage to the coracoacromial arch will affect the anterosuperior stability of the shoulder joint. The greater damage to the coracoacromial arch will lead to the lower anterosuperior stability of the shoulder joint.
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The present study was performed to provide an anatomical basis of the coracoacromial (CA) arch and the articular surfaces of the scapula which can be applied to the diagnosis and treatment of some common shoulder problems. The standard dimensions and the range of variation of the CA arch, the acromial articular surface and the glenoid cavity were investigated in 114 dry scapulae obtained from 57 (male, 35 ; female, 22) Korean cadavers ranging in age from 18 to 97 years (average age of 67). The results were as follows : 1. The length (46.3mm), width(25.2mm), thickness (8.2mm) and height (4.5mm) of the acromion were measured. The length, width and thickness were significantly larger in the males. The slope of the acromion was 51.5°, and the slope of the scapular spine was 118.5°. 2. The height (13.5mm), slope of the root (138.4°) and the horizontal part (25.3°) of the coracoid process, and the angle between the root and the horizontal part (106.6°) were measured. There were no significant differences between sexes and sides in all morphometric values related to the coracoid process. 3. The length (67.6mm) and height (24.7mm) of the CA arch, the height of the CA ligament from the supraglenoid tubercle (13.1mm), and length of the CA ligament (27.6mm) were measured. Both the length and height of the CA arch and the length of the CA ligament were significantly larger in the males. The slope and anterior and posterior angles of the CA arch were 16.8°, 42.2°, and 34.7°, respectively. 4. The long (13.8mm) and short (8.0mm) diameters of the acromial articular surface were measured, and both diameters were significantly longer in the males. The acromial articular surface was 8.4mm away from the tip of the acromion and extended 1.4mm inferiorly below the inferior surface of the acromion. 5. The long (34.8mm) diameter, and superior (15.0mm), middle (19.5mm), and inferior (25.6mm) short diameters of the glenoid cavity were measured. The long and both superior and inferior short diameters were significantly longer in the males.