A Study on Suprascapular Foramen and Its Clinical Importance: A Cadaveric Study in Western Part of Tamilnadu, India

Background: Suprascapular notch is present along the superior border of the scapula close to the lateral angle, which is converted into a Suprascapular foramen by the transverse Suprascapular ligament. Normally the Suprascapular nerve and vein pass through the foramen below the ligament, while the Suprascapular artery runs above the ligament. Suprascapular nerve entrapment is an interesting clinical condition which is widely involved in this area. Aim of the study: To find out the presence of Suprascapular artery passing along with the Suprascapular nerve and vein within the foramen and any pathology associated with it. Materials and Methods: The proposed study is carried out in the Department of Anatomy, Karpagam Faculty of Medical Sciences and Research, Coimbatore, where 51 well embalmed cadavers of both the sexes and various age groups was utilised. Results: Out of 51 cadavers dissected, we found Suprascapular artery was found passing along with the Suprascapular nerve and vein in 2 of the cadavers, of which one each is found in a male and a female cadaver with an incidence of 3.92%. Conclusion: Studies done earlier pointed out the importance of Suprascapular nerve entrapment, the various causes and predisposing factors responsible for it ,and a knowledge of safe zone around the shoulder region should be known well to the operating surgeon and the available imaging techniques should be utilised by the radiologists in order to avoid the complications while dealing with the Suprascapular nerve entrapment. KEY WORDS: Cadaver, Suprascapular foramen, Suprascapular artery, Nerve entrapment, Transverse Suprascapular ligament.

SUPRASCAPULAR NOTCH AND ITS ANATOMICAL VARIANTS

Introduction: The suprascapular notch is situated medial to the root of coracoid and covered by a variable transverse scapular ligament to form a suprascapular foramen, Various shapes of suprascapular notch are observed. Material and Method: The material for the present study comprised of 30 adult scapulae of unknown sex, obtained from the Department of Anatomy, Skims Medical College, Srinagar. Various shapes of suprascapular notch are observed. Result: Suprascapular notches of following shapes were observed: U, V, J. Some scapulae without notches and foramen were also seen. Conclusion: shape of suprascapular notch is important to understand suprascapular nerve entrapment which causes the supraspinatus and infraspinatus muscles to waste.

Landmarks for Identifying the Suprascapular Foramen Anteriorly: Application to Anterior Neurotization and Decompressive Procedures

BACKGROUND Additional landmarks for identifying the suprascapular nerve at its entrance into the suprascapular foramen from an anterior approach would be useful to the surgeon. OBJECTIVE To identify landmarks for the identification of this hidden site within an anterior approach. METHODS In 8 adult cadavers (16 sides), lines were used to connect the superior angle of the scapula, the acromion, and the coracoid process tip thus creating an anatomic triangle. The suprascapular nerve's entrance into the suprascapular foramen was documented regarding its position within this anatomical triangle. Depths from the skin surface and specifically from the medial-most point of the clavicular attachment of the trapezius to the suprascapular nerve's entrance into the suprascapular foramen were measured using calipers and a ruler. The clavicle was then fractured and retracted superiorly to verify the position of the nerve's entrance into the suprascapular foramen. RESULTS From the trapezius, the nerve's entrance into the foramen was 3 to 4.2 cm deep (mean, 3.5 cm). The mean distance from the tip of the corocoid process to the suprascapular foramen was 3.8 cm. The angle best used to approach the suprascapular foramen from the surface was 15° to 20°. CONCLUSION Based on our study, an anterior suprascapular approach to the suprascapular nerve as it enters the suprascapular foramen can identify the most medial fibers of the trapezius attachment onto the clavicle and insert a finger at an angle of 15° to 20° laterally and advanced to an average depth of 3.5 cm.