PURPOSE: To identify the morphological patterns of suprascapular notch stenosis. METHODS: Suprascapular notch space capacity was assessed by morphometric analysis of 333 dry scapulae. Suprascapular notch parameters-superior transverse distance, middle width, depth, medial border length and lateral border length-were measured. The probable suprascapular notch stenosis was referenced by (1) comparing each obtained parameter measurement to the range of the suprascapular nerve diameter, and (2) quantifying the reduced parameters. Finally, the morphological pattern was determined based on the collective reduction of the parameters and their alignments. RESULTS: Five types of suprascapular notch based on depth to superior transverse distance ratio were identified and assessed. Type-I showed low incidence of stenosis (6/333) and low frequency within type (6/28) with potential risk of horizontal compression. Type-II showed relatively low incidence of stenosis (9/333) and low frequency within type (9/50) with undetermined pattern. Type-III showed relatively higher incidence of stenosis (47/333) but low frequency within type (47/158) with potential risk of vertical compression. Type-IV (foramen) showed low incidence of stenosis (6/333) and relatively lower frequency within type (6/26) with potential risk of encircled compression. Finally, type-V (discrete) showed relatively high incidence of stenosis (40/333) and high frequency within type (40/71) with potential risk of vertical compression. The suprascapular notch was found to be stenosed beyond its capacity to accommodate the suprascapular nerve in 49/333. Type-V is at most risk followed by Type-III. CONCLUSIONS: Suprascapular notch stenosis takes three morphological patterns: horizontal, vertical or mixed. An osteoplasty of suprascapular notch margins may be required beside the common surgical approach of the superior transverse scapular ligamentectomy.

College of Polytechnics Jihlava Czech Republic

Department of Anatomy 1st Faculty of Medicine Charles University Prague Czech Republic

Department of Anatomy 2nd Faculty of Medicine Charles University 5 Uvalu 84 150 06 Prague Czech Republic

Department of Orthopaedics 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

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$a Al-Redouan, Azzat, $u Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic. azzat.al-redouan@lfmotol.cuni.cz $d 1982- $7 xx0307844

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$a The morphological stenosis pattern of the suprascapular notch is revealed yielding higher incidence in the discrete type and elucidating the inevitability of osteoplasty in horizontally oriented stenosis / $c A. Al-Redouan, R. Hudak, O. Nanka, D. Kachlik

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$a PURPOSE: To identify the morphological patterns of suprascapular notch stenosis. METHODS: Suprascapular notch space capacity was assessed by morphometric analysis of 333 dry scapulae. Suprascapular notch parameters-superior transverse distance, middle width, depth, medial border length and lateral border length-were measured. The probable suprascapular notch stenosis was referenced by (1) comparing each obtained parameter measurement to the range of the suprascapular nerve diameter, and (2) quantifying the reduced parameters. Finally, the morphological pattern was determined based on the collective reduction of the parameters and their alignments. RESULTS: Five types of suprascapular notch based on depth to superior transverse distance ratio were identified and assessed. Type-I showed low incidence of stenosis (6/333) and low frequency within type (6/28) with potential risk of horizontal compression. Type-II showed relatively low incidence of stenosis (9/333) and low frequency within type (9/50) with undetermined pattern. Type-III showed relatively higher incidence of stenosis (47/333) but low frequency within type (47/158) with potential risk of vertical compression. Type-IV (foramen) showed low incidence of stenosis (6/333) and relatively lower frequency within type (6/26) with potential risk of encircled compression. Finally, type-V (discrete) showed relatively high incidence of stenosis (40/333) and high frequency within type (40/71) with potential risk of vertical compression. The suprascapular notch was found to be stenosed beyond its capacity to accommodate the suprascapular nerve in 49/333. Type-V is at most risk followed by Type-III. CONCLUSIONS: Suprascapular notch stenosis takes three morphological patterns: horizontal, vertical or mixed. An osteoplasty of suprascapular notch margins may be required beside the common surgical approach of the superior transverse scapular ligamentectomy.

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$a Hudak, Radovan $u Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic $u Department of Orthopaedics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic

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$a Nanka, Ondrej $u Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic $u Department of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic

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$a Kachlik, David $u Department of Anatomy, Second Faculty of Medicine, Charles University, V Uvalu 84, 150 06, Prague, Czech Republic $u College of Polytechnics, Jihlava, Czech Republic

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