|Year : 2020 | Volume
| Issue : 2 | Page : 72-74
A study on morphology of suprascapular notch with specific emphasis on type-VI of rengachary classification
Tushar V Nayak1, Subhash M Gujar2
1 Assistant Professor, Department of Anatomy, GMERS Medical College, Mehsana, Gujarat, India
2 Associate Professor, Department of Anatomy, GMERS Medical College, Mehsana, Gujarat, India
|Date of Submission||01-Aug-2019|
|Date of Decision||22-Oct-2019|
|Date of Acceptance||24-Dec-2019|
|Date of Web Publication||10-Sep-2020|
Subhash M Gujar
GMERS Medical College, Vadnagar, Mehsana - 384 315, Gujarat
Source of Support: None, Conflict of Interest: None
Background and Aim: Superior border is shortest border of scapula which is marked by suprascapular notch bridged by transverse suprascapular ligament. Beneath this ligament passes the suprascapular nerve. Narrow notch and Type-VI suprascapular notch are one of the risk factors for suprascapular neuropathy. This study is done to study morphological variation of suprascapular notch. Knowledge of various types of suprascapular notch will help the clinician in early diagnosis and surgical treatment. Materials and Methods: A total of 525 human scapulae were taken to study morphology of suprascapular notch at the Anatomy Department, GMERS Medical College, Vadnagar and at B. J. Medical College, Ahmedabad. Age and sex of scapulae were not established. Digital camera is used to take photos of different suprascapular notch and classified as per Rengachary classification. Results: As per Rengachary classification in our study, of 525 scapulae most common suprascapular notch type is Type-III 47.1%, least common is Type-V 1.9%, and incidence of Type-VI is 8.9%. Conclusion: A study of different types of suprascapular notch can help the physician in screening high risk patient as well as diagnosis and treatment of suprascapular neuropathy disorder.
Keywords: Morphology, superior transverse scapular ligament, suprascapular nerve, suprascapular notch
|How to cite this article:|
Nayak TV, Gujar SM. A study on morphology of suprascapular notch with specific emphasis on type-VI of rengachary classification. Natl J Clin Anat 2020;9:72-4
|How to cite this URL:|
Nayak TV, Gujar SM. A study on morphology of suprascapular notch with specific emphasis on type-VI of rengachary classification. Natl J Clin Anat [serial online] 2020 [cited 2020 Nov 28];9:72-4. Available from: http://www.njca.info/text.asp?2020/9/2/72/294749
| Introduction|| |
The superior border of scapula is shortest one having suprascapular notch just medial to the base of coracoid process. One of the branches of upper trunk of brachial plexus is suprascapular nerve which runs in posterior triangle of the neck. It passes through the suprascapular notch below the transverse suprascapular ligament. It supplies the supraspinatus and infraspinatus muscle as well as shoulder and acromioclavicular joint. Rengachary et al. described the suprascapular nerve irritation and compression leads to suprascapular neuropathy during its passage through suprascapular foramen. Suprascapular nerve entrapment causes pain, weakness, and atrophy of the muscles and joint it supplied.
The aim is to classify and record the different types of suprascapular notch in human scapula specimen and particularly the percentage of Type-VI of Rengachary classification which is the risk factor for suprascapular neuropathy.
| Materials and Methods|| |
A total of 525 human scapulae were studied of unknown age and sex at Anatomy Department, GMERS Medical College, Vadnagar and at B. J. Medical College, Ahmedabad, after taking permission from the head of institute and department. The scapulae with broken superior border or suprascapular notch were not included in the study. The study was done from February 2017 to March 2018. Digital camera is used to take photos of different notch types. Rengachary et al. classified VI different types of suprascapular notch depending on the morphology. We studied suprascapular notches and classified as per Rengachary classification as shown in [Table 1].
| Results|| |
In the present study, of 525 scapulae, the most common type is Type-III 47.1%, least common is Type-V 1.9%, and percentage of Type-VI is 8.9% [Table 2].
|Table 2: Percentage of different types of suprascapular notch in the present study as per Rengachary classification|
Click here to view
As shown in [Figure 1], representative photograph of different types of suprascapular notch in the present study.
|Figure 1: Representative photographs of the various notch types from our study|
Click here to view
| Discussion|| |
Anatomical variation of the suprascapular notch is clinically related to the suprascapular neuropathy. A narrow suprascapular notch with Type-VI act as risk factor for suprascapular neuropathy syndrome.
In the present study, the most common Type of suprascapular notch is Type-III 47.1% this is in accordance with the study done by Rengachary et al., Sinkeet et al., Sangam et al., and Kannan et al. [Table 3].
|Table 3: Comparison of various types of suprascapular notch using Rengachary et al. classification|
Click here to view
The least common type of suprascapular notch is Type-V 1.9% this is in accordance with the study done by Kannan et al. [Table 3].
In the present study, the incidence of Type-VI suprascapular notch is 8.9% which is in accordance with the study done by Kannan et al., Vedha and Vidulatha in Indian population [Table 4].
|Table 4: Comparison of percentage of Type-VI suprascapular notch in different population|
Click here to view
The incidence of Type-VI suprascapular notch in Indian population is relatively significant in comparison to other ethnic population. The incidence is more in Turkish (ranging from 6% to 12.5%) followed by Indian (ranging from 1%-10%) followed by French (ranging from 5% to 6.5%) and American (ranging from 1% to 4%) [Table 4].
| Conclusion|| |
Suprascapular neuropathy can be caused by Type-VI suprascapular notch and other Types of suprascapular notch. The knowledge of such variation is great help to physician for diagnosis and treatment. The study of suprascapular notch by radiology and imaging techniques such as X-ray, magnetic resonance imaging (MRI), computed tomography-scan, can be used for large population screening.
Limitations of study
We have done this study on dry human scapula. This study can be done by MRI of scapular region correlating findings with symptoms of suprascapular neuropathy.
My sincere thanks to Anatomy Department at B. J. Medical College for providing study material.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Moore KL, Dalley AF, Agar AM. Clinically Oriented Anatomy. 7th
ed. New Delhi: Lippincott Williams & Wilkins; 2014. p. 675.
Snell RS. Clinical Anatomy. 9th
ed. New Delhi: Lippincott Williams & Wilkins; 2012. p. 361.
Rengachary SS, Neff JP, Singer PA, Brackett CE. Suprascapular entrapment neuropathy: A clinical, anatomical, and comparative study. Part 1: Clinical study. Neurosurgery 1979;5:441-6.
Zehetgruber H, Noske H, Lang T, Wurnig C. Suprascapular nerve entrapment. A meta-analysis. Int Orthop 2002;26:339-43.
Rengachary SS, Burr D, Lucas S, Hassanein KM, Mohn MP, Matzke H. Suprascapular entrapment neuropathy: A clinical, anatomical, and comparative study. Part 2: Anatomical study. Neurosurgery 1979;5:447-51.
Edeland HG, Zachrisson BE. Fracture of the scapular notch associated with lesion of the suprascapular nerve. Acta Orthop Scand 1975;46:758-63.
Sinkeet SR, Awori KO, Odula PO, Ogeng'o JA, Mwachaka PM. The suprascapular notch: Its morphology and distance from the glenoid cavity in a Kenyan population. Folia Morphol (Warsz) 2010;69:241-5.
Sangam MR, Sarada Devi SS, Krupadanam K, Anasuya K. A study on the morphology of the suprascapular notch and its distance from the glenoid cavity. J Clin Diagn Res 2013;7:189-92.
Kannan U, Kannan NS, Anbalagan J, Rao S. Morphometric study of suprascapular notch in Indian dry scapulae with specific reference to the incidence of completely ossified superior transverse scapular ligament. J Clin Diagn Res 2014;8:7-10.
Albino P, Carbone S, Candela V, Arceri V, Vestri AR, Gumina S. Morphometry of the suprascapular notch: Correlation with scapular dimensions and clinical relevance. BMC Musculoskelet Disord 2013;14:172.
Pushpa NB, Bajpe R. Morphology of suprascapular notch: A study on 176 dry scapulae. Int J Anat Res 2015;3:1642-5.
Vedha S, Vidulatha K. A morphological study of suprascapular notch and incidence of ossification of superior transverse scapular ligament in South Indian dry scapulae. Int J Cur Res Rev 2017;9:45-9.
Vallois HV. The acromial bone in the human race. L' Anthropogie 1925;35:977-1022.
Olivier G. Anthropological practice. Le Scapulum. Paris: Vigot Freres; 1960.
Edelson JG. Bony bridges and other variations of the suprascapular notch. J Bone Joint Surg Br 1995;77:505-6.
Ticker JB, Djurasovic M, Strauch RJ, April EW, Pollock RG, Flatow EL, et al
. The incidence of ganglion cysts and other variations in anatomy along the course of the suprascapular nerve. J Shoulder Elbow Surg 1998;7:472-8.
Bayramoǧlu A, Demiryürek D, Tüccar E, Erbil M, Aldur MM, Tetik O, 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.
Urgüden M, Ozdemir H, Dönmez B, Bilbaşar H, Oǧuz N. Is there any effect of suprascapular notch type in iatrogenic suprascapular nerve lesions? An anatomical study. Knee Surg Sports Traumatol Arthrosc 2004;12:241-5.
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;20:135-9.
Wang HJ, Chen C, Wu LP, Pan CQ, Zhang WJ, Li YK. Variable morphology of the suprascapular notch: An investigation and quantitative measurements in Chinese population. Clin Anat 2011;24:47-55.
Polguj M, Jędrzejewski KS, Podgórski M, Topol M. Correlation between morphometry of the suprascapular notch and anthropometric measurements of the scapula. Folia Morphol (Warsz) 2011;70:109-15.
Malik GS, Shukla L, Chabbra S, Gaur N. Morphometric analysis of the suprascapular notch. Internet J Biol Anthropol 2012;5:1-5.
Tubbs RS, Nechtman C, D'Antoni AV, Shoja MM, Mortazavi MM, Loukas M, et al
. Ossification of the suprascapular ligament: A risk factor for suprascapular nerve compression? Int J Shoulder Surg 2013;7:19-22.
] [Full text]
Sharma R, Sharma R, Singla RK, Kullar JS, Sharma T. Suprascapular notch: A morphometric and morphologic study in North Indian population. Int J Anat Res 2015;3:1306-11.
Chhabra N, Prakash S, Ahuja MS. Morphometry and morphology of suprascapular notch: It's importance in suprascapular nerve entrapment. Int J Anat Res 2016;4:2536-41.
Desai U, Rathwa A, Chavda S. Morphological classification of suprascapular notch in dry scapulae from population of Gujarat: A database for shoulder arthroscaopy. Int J Anat Res 2018;6:5191-6.
[Table 1], [Table 2], [Table 3], [Table 4]