The safe zone for avoiding suprascapular nerve injury during shoulder arthroscopy: an anatomical study on 500 dry scapulae

A computed tomography study on the correlation between the morphometry of the suprascapular notch and anthropometric measurements of the scapula

“…Also, as the SSN is variform, its shape and size are the most important factors in the aetiopathology of SN entrapment [1,11,17]. Therefore, knowledge of the morphology of the suprascapular region, especially the SSN, is particularly important in various techniques associated with arthroscopic SN decompression [3,7,8] or ultrasound-guided blockage of the SN [15].…”

Safe Areas for the Placement of Standard Shoulder Arthroscopy Portals: An Anatomical Study

“…Subsequently, bony landmarks of the acromion, clavicle and acromioclavicular joint were identified and marked using a surgical marker. Finally, the SPP, and SAP were placed following the classic description in the literature (McGinty et al, 2005;Meyer et al;Gumina et al). Although there are other shoulder portals (not evaluated in this study), SPP and SAP are the most commonly used.…”

“…For example, during the placement of posterior portals, risks of injuring the posterior humeral circumflex artery (Naidoo et al, 2014), the circumflex artery of the scapula (Ebraheim et al, 2010), the suprascapular nerve (Bigliani et al, 1990;Shishido & Kikuchi, 2001;Gumina et al, 2011), branches of the infraspinous artery (Naidoo et al), and muscle vessels that provide irrigation to the joint capsule have been documented (Andary & Petersen, 2002). During the placement of anterior portals, their proximity to the cephalic vein (Di Giacomo & Costantini, 2004;Meyer et al), anterior humeral circumflex artery, and musculocutaneous nerve has been described (Di Giacomo & Costantini).…”

An osteological study of measurement of safe zone to prevent iatrogenic suprascapular nerve injury and its correlation with type of suprascapular notch

“…Safe Zone is defined as an area within which iatrogenic injury to the suprascapular nerve is likely to be avoided. 15,16,[20][21][22][23][24] The safe zone presents certain safe limits: (1) The posterior limit is represented as the distance measured from the supraglenoid tubercle to the deepest point of the suprascapular notch. (2) The posterosuperior limit is represented as the distance measured from the midline of the posterior glenoid rim to the base of the scapular spine.…”

“…(3) The distance between base of scapular spine and deepest point of the suprascapular notch. 23,24 The precise knowledge of morphology in the parascapular/shoulder girdle region (especially, variations of SSN) is particularly essential to avoid iatrogenic nerve injuries during surgeries. The measurements of 'safe zone' help clinicians for safe advancement during surgeries.…”