Authors : Usha Dandekar, Kundankumar Dandekar
DOI : 10.18231/j.ijcap.2019.039
Volume : 6
Issue : 2
Year : 2019
Page No : 173-178
The two ends of suprascapular notch [SSN] are bridged by a sturdy fibrous band like superior transverse scapular ligament [STSL]. This bridging is responsible to convert the notch into foramen providing passage to suprascapular nerve. This anatomical relation has potential of compressing the nerve which may result in a condition called suprascapular nerve entrapment syndrome (SNES). A cadaveric morphological study was undertaken on 31 cadavers to study the details of morphology of STSL considering its role in causation of SNES and to elucidate the anatomical basis of the entrapment neuropathy. The results revealed single STSL in 98.4% and bifid STSL in 1.6%. According to shape, fan shaped STSL were found in 74.2%, band shaped STSL in 24.2% and bifid STSL in 1.6%. The mean cross sectional area of suprascapular opening was 32.89 mm2, 18.86mm2 and 22mm2 in specimens with fan shaped, band shaped and bifid STSL respectively. The anatomical relations of suprascapular vessels to STSL were recorded as: First type (29.03%) showed the presence of suprascapular vein below the STSL and the suprascapular artery above it. The second type (54.84%), revealed the placement of both suprascapular artery and vein were above the ligament. The third type showed the passage of all the structures i.e. nerve, vein and artery below the ligament (16.13%). Complete ossification of STSL was noted in only one specimen while thirteen specimens showed partial ossification. Etiology of SNES consists of apparent incriminating anatomy in the form of shape and type of STSL. The surgical relief aims at decompression of suprascapular nerve by excising the STSL. Cadaveric study of STSL providing idea of variations of its morphology shall be of help to surgeons and arthroscopist to plan their approach in treatment of SNES.
Keywords: Superior transverse scapular ligament, Suprascapular nerve entrapment syndrome.