Anatomical considerations for safe scapular resection in snapping scapula syndrome

Area of Science:

• Orthopedic surgery
• Anatomy
• Surgical safety

Background:

• Snapping scapula syndrome treatment involves resecting the superomedial scapula angle.
• This procedure carries a risk of iatrogenic injury to the suprascapular nerve.
• Understanding the anatomical relationship between the resection site and the suprascapular notch is crucial for surgical safety.

Purpose of the Study:

• To determine the distance between the planned arthroscopic resection site of the superomedial scapula angle and the suprascapular notch.
• To assess the safety margin for the suprascapular nerve during this procedure.
• To identify anatomical factors influencing the risk of nerve injury.

Main Methods:

• The study analyzed 92 intact dry adult scapulae.
• Standard superior Bell's and medial portals were used for simulated arthroscopic resection.
• Measurements were taken from the suprascapular notch to the planned resection site on the scapula's upper border.

Main Results:

• A safe margin of over 10mm between the resection site and the suprascapular notch was found in 85.9% of specimens.
• A margin of less than 10mm was observed in 14.1% of cases, indicating potential vulnerability.
• A significant positive correlation existed between the resection margin and the scapula's superior angle-acromion distance.

Conclusions:

• Arthroscopic resection of the superomedial scapula angle generally provides a safe margin for the suprascapular nerve.
• A small percentage of cases (14.1%) present a risk of suprascapular nerve injury.
• Wider scapulae may be associated with a safer surgical outcome, suggesting patient-specific anatomical considerations are important.