A Morphometric and Morphological Analysis of Superior Border of Dry Scapulae

Abstract

Aim: The recognition of the scapula anatomy and visible variations is important in surgical treatments and arthroscopic procedures in case of any diseases of the shoulder. The morphological and morphometric characteristics of the scapular notch on the superior margin are very important. Because compression of the suprascapular nerve extending inside the scapular notch causes entrapment neuropathy. Therefore, the present study was planned in order to contribute to us as well as practitioners about morphometric and morphological characteristics of the superior margin of the scapula.
Materials and Methods: Morphometric measurements (SL: scapula length; SW: scapula width; SI: scapula index; STD: superior transverse diameter of the scapular notch; MTD: medial transverse diameter of the scapular notch; VD: vertical diameter) were performed on 90 (50 left; 40 right) scapulae of Turkish population without unknown age and gender. Furthermore, the superior scapular margin and the scapular notch were categorized through observational classification as well as measurement.
Results: The mean scapular width was detected 98.87±7.71 mm on the right and 94.38±13.01 mm on the left. The scapula index was measured 67.51±4.40 mm on the right and 63.80±8.29 mm on the left. The SL, STD, and VT was larger on the left; the SW, SI, and MTD were larger on the right. The difference between right and left for the SW and SI measurements was statistically significant (p<0.005). The most common scapular notch appearance, the U shape (64.4%) was the most common scapular notch shape as VD>MTD (%48.9). The most common superior margin type was moderately oblique (41.1%).
Conclusion: We believe that the data obtained would be helpful for orthopedic surgeons in intramedullary nailing and radiologists in the differential diagnosis of some osteolytic lesions in that region. Furthermore, scapula measurements would help to identify the gender and race in forensic medicine and anthropology. 

Keywords

• The scapular notch
• scapulae
• variation
• moprhometry

Kaynakça

1. 1. Standring S. Pectoral girdle and upper limb. In: Gray’s Anatomy: The Anatomical Basis of Clinical Practices. Johnson D & Collins P, Eds, Churchill Livingstone, New York, USA, 40th edition. 2008;793-821.
2. 2. Thompson W, Kopell H. Peripheral entrapment neuropathies of the upper extremity. N Engl J Med. 1959;25:1261-1265.
3. 3. Polguj M, Rożniecki J, Sibiński M, et al. The variable morphology of suprascapular nerve and vessels at suprascapular notch: a proposal for classification and its potential clinical implications. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23:1542-8.
4. 4. Zehetgruber H, Noske H, Lang T, Wurnig C. Suprascapular nerve entrapment: a meta-analysis. Int Orthop 2002;26:339–43.
5. 5. Biswas A, Pal A, Roy H, Datta I, Ghoshal AK. Scapular morphometry-A study in West Bengal population with 2021.
6. 6. Rengachary SS, Burr D, Lucas S, et al. Suprascapular entrapment neuropathy: a clinical, anatomical, and comparative study. Part 2: anatomical study. Neurosurgery. 1979;5:447-51.
7. 7. Okeke C, Ukoha U, Ukoha C, et al. Morphometric study of the suprascapular notch in Nigerian dry scapulae. African Journal of Biomedical Research. 2022;25:53-8.
8. 8. Polguj M, Jędrzejewski KS, Podgórski M, Topol M. Correlation between morphometry of the suprascapular notch and anthropometric measurements of the scapula. Folia Morphologica. 2011:70:109-15.

9. 9. Singroha R, Verma U, Rathee SK. Anatomical variations in scapula: A study with correlation to gender and sides. Journal of the Anatomical Society of India. 2021;70:101.
10. 10. Shanahan EM, Ahern M, Smith M, et al. Suprascapular nerve block (using bupivacaine and methylprednisolone acetate) in chronic shoulder pain. Annals of the Rheumatic Diseases. 2003;62:400-6.
11. 11. Prescher A, Klümpen T. Does the area of the glenoid cavity of the scapula show sexual dimorphism?. Journal of Anatomy. 1995;186:223.
12. 12. El-Din WA N, Ali MHM. A morphometric study of the patterns and variations of the acromion and glenoid cavity of the scapulae in Egyptian population. Journal of Clinical and Diagnostic Research: JCDR. 2015;9:AC08.4
13. 13. Taser FA, Basaloglu H. Morphometric dimensions of the scapula. Ege Journal of Medicine. 2003;42:73-80.
14. 14. Coskun N, Karaali K, Cevikol C, et al. Anatomical basics and variations of the scapula in Turkish adults. Saudi Medical Journal. 2006;27:1320.
15. 15. Aydemir AN, Yücens M, Şule O, Skapula Örneklerinin Morfometrik Değerlendirmesi ve Anatomik Varyasyonları. Antropoloji. 2020;39:57-9.
16. 16. Kavita P, Singh J. Morphology of coracoid process and glenoid cavity in adult human scapulae. International Journal of Analytical, Pharmaceutical and Biomedical Sciences. 2013;2:62-5.
17. 17. Chhabra N, Prakash S, Ahuja MS. Morphometry and morphology of suprascapular notch: its importance in suprascapular nerve entrapment. Int J Anat Res. 2016;4:2536-41.
18. 18. Nazir M, Shah BA. Shaheen Sha observational study at GMC Srinagar, Kashmir. International Jo Key words.
19. 19. Rajeswari K, Ramalingam P. Study of morphometric analysis of scapula and scapular indices in Tamil Nadu population. IOSR J Dent Med Sci. 2018;17:37-42.
20. 20. Singh J, Pahuja K, Agarwal R. Morphometric parameters of the acromion process in adult human scapulae. Indian J Basic Appl Med Res. 2013;2:1165-70.
21. 21. Natsis K, Totlis T, Tsikaras P, et al. Proposal for classification of the suprascapular notch: a study on 423 dried scapulas. Clin Anat. 2007;20:135–9.
22. 22. Sinkeet SR, Awori KO, Odula PO, et al. The suprascapular notch: its morphology and distance from the glenoid cavity in a Kenyan population. Folia Morphologica. 2010;69:241-5.
23. 23. Wang HJ, Chen C, Wu LP, et al. Variable morphology of the suprascapular notch: an investigation and quantitative measurements in Chinese population. Clinical Anatomy.2011;24:47-55.
24. 24. Albino P, Carbone S, Candela V, et al. Morphometry of the suprascapular notch: correlation with scapular dimensions and clinical relevance. BMC Musculoskeletal Disorders. 2013;14:1-10.
25. 25. Vandana R, Patil S. Morphometric study of suprascapular notch. National Journal of Clinical Anatomy. 2013;2:140.
26. 26. Gopal K, Choudhary AK, Agarwal J, Kumar V. Variations in suprascapular notch morphology and its clinical importance. Int J Res Med Sci. 2015;3:301-6.
27. 27. Boyan N, Ozsahin E, Kizilkanat E, et al. Assessment of scapular morphometry. International Journal of Morphology. 2018;36:1305-9.
28. 28. Adewale, AO, Segun O O, Usman IM, et al. Morphometric study of suprascapular notch and scapular dimensions in Ugandan dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament. BMC Musculoskeletal Disorders. 2020;21:1-10.
29. 29. Mahdy AA, Shehab AA. Morphometric variations of the suprascapular notch as a potential cause of neuropathy: anatomical study. J Am Sci. 2013;9:189-97.
30. 30. Polguj M, Sibiński M, Grzegorzewski A, et al. Variation in morphology of suprascapular notch as a factor of suprascapular nerve entrapment. International Orthopaedics. 2013;37:2185-92.
31. 31. Sharma R, Sharma R, Singla RK, et al. Suprascapular notch: a morphometric and morphologic study in North Indian population. 2015.
32. 32. Ahmed SM. Morphometry of suprascapular notch in Egyptian dry scapulae and its correlation with measurements of suprascapular nerve safe zone for clinical consideration. Eur j Anat. 2018;22:441-8.
33. 33. Bhatia DN, de Beer JF, van Rooeyn KS, du Toit DF. Arthroscopic suprascapular nerve decompression at the suprascapular notch. Arthroscopy. 2006;22:1009-13.
34. 34. Antoniadis G, Richter HP, Rath S, et al. Suprascapular nerve entrapment: experience with 28b cases. J Neurosurg. 1996;85:1020–25.
35. 35. Zhang L, Guo X, Liu Y, et al. Classification of the superior angle of the scapula and its correlation with the suprascapular notch: a study on 303 scapulas. Surgical and Radiologic Anatomy. 2019;41:377-83.
36. 36. Khattab M, Ahmed HK, El-shazly M, et al. A study of the anatomical variations in the shape and diameter of the suprascapular notch and spinoglenoid notch in dried human scapulae. The Medical Journal of Cairo University. 2019;87:741-6.
37. 37. Kastamoni Y, Akgün S, Öztürk K, Ayazoğlu M. Incısura scapulae morfometrisi ve tiplendirilmesi. SDÜ Tıp Fakültesi Dergisi. 2020;27:309-13.
38. 38. Kale A, Edizer M, Aydın E, et al. Çorumlu U.Scapula morfometrisinin incelenmesi. Dirim. 2004;26-35.
39. 39. Bayramoğlu A, Demiryürek D, Tüccar ERAY, et al. Variations in anatomy at the suprascapular notch possibly causing suprascapular nerve entrapment: an anatomical study. Knee Surgery, Sports Traumatology, Arthroscopy. 2003;11:393-8.