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Kumar A, Sharma A, Singh P
Correspondence: Dr Anu Sharma, anuashwani2003@yahoo.com
ABSTRACT
INTRODUCTION Detailed anatomical knowledge of the suprascapular notch (SSN) is important for the management of entrapment neuropathy and interventional procedures. The objective of the present study was to collect data on the morphological features and anatomical variations of the SSN in an Indian population.
METHODS We studied 268 human scapulae of unknown sex (126 right-sided, 142 left-sided) taken from the Department of Anatomy, Dayanand Medical College and Hospital, India. SSNs were classified as either type I, II, III, IV or V, based on the shape of the inferior border of the incisura, and comparison of the SSN’s vertical and transverse diameters. The shape of the SSN (i.e V- or U-shaped), if present, was also recorded.
RESULTS Type II SSN was the most common (50.00%), followed by type I, type IV and type III (32.46%, 9.70% and 7.84%, respectively). For right-sided type II SSNs, the transverse and vertical diameters were 9.1 ± 3.2 mm and 5.2 ± 1.9 mm, respectively, while those for left-sided type ll SSNs were 9.2 ± 2.4 mm and 5.1 ± 1.8 mm, respectively. Generally, the transverse diameter of type II SSN was found to be greater than that of type III SSN. The incidence of U-shaped SSN was 51.49%, while that of V-shaped SSN was 2.99%.
CONCLUSION This study of the morphometrical characteristics and anatomical variations of SSN provides an anatomical database of SSN in the Indian context. This database will be of use in surgical procedures, as the information can be used to ensure adequate access to and complete decompression of the suprascapular nerve.
Keywords: scapula, suprascapular nerve entrapment, suprascapular notch
Singapore Med J 2014; 55(1): 41-44; http://dx.doi.org/10.11622/smedj.2014009
REFERENCES
| 1. Berry MM, Stranding SM, Bannister LH, eds. Nervous System. In: Gray H, Williams PL, Bannister LH, eds. Gray's Anatomy: the anatomical basis of medicine and surgery. 38th ed. Edinburgh: Churchill Livingstone, 1995. | ||||
| 2. Gelberman RH, Verdeck WN, Brodhead WT. Supraclavicular nerve-entrapment syndrome. J Bone Joint Surg Am 1975; 57:119. PMid:1123360 | ||||
| 3. Holzgraefe M, Kukowski B, Eggert S. Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players. Br J Sports Med 1994; 28:177-9. http://dx.doi.org/10.1136/bjsm.28.3.177 | ||||
| 4. Padua L, LoMonaco M, Padua R, et al. Suprascapular nerve entrapment. Neurophysiological localization in 6 cases. Acta Orthop Scand 1996; 67:482-4. http://dx.doi.org/10.3109/17453679608996673 | ||||
| 5. Post M, Mayer J. Suprascapular nerve entrapment. Clin Orthop Relat Res 1987; 223:126-36. PMid:3652566 | ||||
| 6. Tubbs RS, Smyth MD, Salter G, Oakes WJ. Anomalous traversement of the suprascapular artery through the suprascapular notch: a possible mechanism for undiagnosed shoulder pain? Med Sci Monit 2003; 9:116-9. | ||||
| 7. Cohen SB, Dines DM, Moorman CT. Familial calcification of superior transverse scapular ligament causing neuropathy. Clin Orthop Relat Res 1997; 334:131-5. http://dx.doi.org/10.1097/00003086-199701000-00017 | ||||
| 8. Ticker JB, Djurasovic M, Strauch RJ, et al. The incidence of ganglion cysts and other variation in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 1998; 7:472-78. http://dx.doi.org/10.1016/S1058-2746(98)90197-5 | ||||
| 9. Bayramo?lu A, Demiryürek D, Tüccar E, et al. Variations in anatomy at the suprascapular notch, possibly causing suprascapular nerve entrapment: an anatomical study. Knee Surg Sports Traumatol Arthrosc 2003; 11:393-8 http://dx.doi.org/10.1007/s00167-003-0378-3 | ||||
| 10. Zehetgruber H, Noske H, Lang T, Wurning C. Suprascapular nerve entrapment. A meta-analysis. Int Orthop 2002; 26:339-43. http://dx.doi.org/10.1007/s00264-002-0392-y | ||||
| 11. Standring SM, Ellis H, Healy JC, et al. Pectoral girdle and Upper Limb. In: Standring SM, ed. Gray's Anatomy, 39th ed. Edinburgh: Churchill-Livingstone, 2005:847. | ||||
| 12. Natsis K, Totlis T, Tsikaras P, et al. Proposal for classification of suprascapular notch: a study on 423 dried scapulas. Clin Anat 2007; 20:135-9. http://dx.doi.org/10.1002/ca.20318 | ||||
| 13. Khan MA. Complete ossification of the superior transverse scapular ligament in an Indian male adult. Int J Morphol 2006; 24:195-6. http://dx.doi.org/10.4067/S0717-95022006000300013 | ||||
| 14. Dunkelgrun M, Iesaka K, Park SS, Kummer FJ, Zuckerman JD. Interobserver reliability and intraobserver reproducibility in suprascapular notch typing. Bull Hosp Jt Dis 2003; 61:118-22. PMid:15156809 | ||||
| 15. Rengachary SS, Burr D, Lucas S, et al. Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 2: anatomical study. Neurosugery 1979: 5:447-51. http://dx.doi.org/10.1227/00006123-197910000-00007 | ||||
| 16. Ofusori DA, Ude RA, Okwuonu CU, Adesanya OA. Complete absence of suprascapular notch in a Nigerian scapula: A possible cause of suprascapular nerve entrapment. Int J Shoulder Surg 2008; 2:85-6. http://dx.doi.org/10.4103/0973-6042.44146 | ||||
| 17. Wang HJ, Chen C, Wu LP, et al. Variable morphology of suprascapular notch: an investigation and quantitative measurements in Chinese population. Clin Anat 2011; 24:47-55. http://dx.doi.org/10.1002/ca.21061 | ||||
| 18. Hrdli?ka A. The scapula: Visual observations. Am J Phys Anthropol 1942; 29:73-94. http://dx.doi.org/10.1002/ajpa.1330290107 | ||||
| 19. Iqbal K, Iqbal R, Khan SG. Anatomical variations in shape of suprascapular notch of scapula. J Morphol Sci 2010; 27:1-2. | ||||
| 20. Alon M, Weiss S, Fishel B, Dekel S. Bilateral suprascapular nerve entrapment syndrome due to anomalus transverse scapula ligaments. Clin Orthop Relat Res 1988; 234:31-3. PMid:3409593 | ||||