Welcome to International Journal of Anatomy and Research

Type of Article: Original Research

Year: 2015 | Volume 3 | Issue 4 | Page No. 1536-1542

Date of Publication: 30-11-2015

DOI: http://dx.doi.org/10.16965/ijar.2015.274

VARIATIONS OF SUPRASCAPULAR NOTCH IN ADULT EGYPTIAN SCAPULAE

Gamal Hamed El-Syed Hassanein, Mohammad Bahgat Ali.

Department of Anatomy, Faculty of Medicine, Zagazig University, Egypt

Address: Dr. Gamal Hamed El-Syed Hassanein, Department of Anatomy, Faculty of Medicine, Zagazig University, Egypt.
E-Mail: gamalhs@hotmail.com

Abstract

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.
KEY WORDS: Egyptian Scapula, Suprascapular Notch, Suprascapular Nerve Entrapment.

References

1. Standring S (Editor-In- Chief), Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC. Section 6 – Pectoral girdle and upper limb Chapter 46 -Pectoral Girdle, Shoulder region and Axilla. In: Gray’s Anatomy The Anatomical Basis of Clinical Practice. 40th ed., Churchill Livingstone,2008:791-822.
2. Polguj M, Jędrzejewski K, Podgórski M, Majos A, Topol M. A proposal for classification of the superior transverse scapular ligament: variable morphology and its potential influence on suprascapular nerve entrapment. J Shoulder Elbow Surg. 2013;22(9):1265-73.
3. Ticker JB, Djurasovic M, Strauch RJ, April EW, Pollock RG, Flatow EL. The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 1998;7(5):472-8.
4. Dunkelgrun M, Iesaka K, Park SS, Kummer FJ, Zuckkerman JD: Interobserver reliability and intraobserver reproducibility in suprascapular notch typing. Bull Hosp Joint Dis 2003;61:118–122.
5. Khan MA. Complete ossification of the superior transverse scapular ligament in an Indian male adult. Int J Morphol 2006;24 (2):195-196.
6. Silva JG, Abidu-Figueiredo M, Fernandes RMP, et al., High incidence of complete ossification of the superior transverse scapular ligament in Brazilians and its clinical implications. Int J Morphol 2007;25(4):855-859.
7. Vorster W, Lange CP, Briët RJ, Labuschagne BC, du Toit DF, Muller CJ, de Beer JF. The sensory branch distribution of the suprascapular nerve: An anatomic study. J Shoulder Elbow Surg 2008;17(3):500-2.
8. Liveson J A,  Bronson M J, and  Pollack M A Suprascapular nerve lesions at the spinoglenoid notch: report of three cases and review of the literature. J Neurol Neurosurg Psychiatry 1991;54(3):241-243.
9. Walsworth MK , Mills JT 3rd, Michener LA. Diagnosing suprascapular neuropathy in patients with shoulder dysfunction: a report of 5 cases.Phys Ther 2004;84(4) : 359-72.
10. Kopell HP, Thompson WAL. Pain and the frozen shoulder. Surg Gynecol Obstet 1959;109:92-96. (cited by Natasis et al, 2007)
11. Iqbal K, Iqbal R, Khan SG. Anatomical variations in shape of suprascapular notch of scapula; J Morphol Sci. 2010;27(1):1-2.
12. Natsis K, Totlis T, Tsikaras P, Appell HJ, Skandalakis P, Koebke J. Proposal for classification of the suprascapular notch: a study on 423 dried scapulas. Clin Anat 2007;20(2):135-9.
13. Wang H J, Chen C, Wu L P, et al. Variable morphology of the suprascapular notch: an investigation and quantitative measurements in Chinese population. Clinical Anatomy 2011;24(1):47-55.
14. Sinkeet SR, Awori KO, Odula, PO, et al. The suprascapular notch: its morphology and distance from the glenoid cavity in a Kenyan population. Folia Morphologia 2010;69(4):241-5.
15. Das S, Suri R and  Kapur V. Ossification of Superior Transverse Scapular Ligament and its Clinical Implications.  Sultan Qaboos Univ Med J. Aug 2007;7(2):157-160.
16. Cummins CA, Messer TM, Nuber GW. Current concepts review -Suprascapular nerve entrapment. J Bone Joint Surg Am. 2000;82(3):415-424
17. Avery BW, Pilon FM, and Barclay JK. Anterior Coracoscapular Ligament and Suprascapular Nerve Entrapment. Clinical Anatomy 2002;15:383-386.

Gamal Hamed El-Syed Hassanein, Mohammad Bahgat Ali. VARIATIONS OF SUPRASCAPULAR NOTCH IN ADULT EGYPTIAN SCAPULAE. Int J Anat Res 2015;3(4):1536-1542. DOI: 10.16965/ijar.2015.274