article · PubMed
Anatomical examination of 138 scapulae shows that the suprascapular notch was present in 97.8 percent of specimens. Morphological assessment reveals that the symmetrical U-shaped type III notch is the most common variation, occurring in 29 percent of cases. Measurements indicate that the average distance from the notch to the supraglenoid tubercle is 28.7 millimetres, varying from 27.3 millimetres in type III notches to 30.1 millimetres in type IV notches. Additionally, the average distance between the posterior rim of the glenoid cavity and the spinoglenoid notch measures 15.8 millimetres. The findings suggest that standard anatomical safe zones commonly relied upon during arthroscopic shoulder surgery may fail to prevent nerve damage across a notable proportion of patients, with the danger being especially pronounced in shoulders displaying type I and type II notches.
Nerve damage during shoulder surgery can lead to chronic pain and reduced mobility. Understanding anatomical variations in the shoulder blade helps surgeons appreciate where standard clearance guidelines might fail. These precise measurements highlight that standard safety margins do not fit every individual, providing a foundation for safer surgical planning and lower rates of nerve entrapment.
This research provides baseline anatomical reference data directly relevant to orthopaedic surgeons and developers of arthroscopic surgical tools and training systems. It represents early-stage anatomical research that can inform surgical guidelines, pre-operative planning software, or specialised shoulder instrumentation to minimise nerve trauma, though clinical protocol adoption remains necessary before direct practical deployment.
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The morphology of the suprascapular notch has been associated with suprascapular entrapment neuropathy, as well as injury to the suprascapular nerve in arthroscopic shoulder procedures. This study aimed to describe the morphology and morphometry of the suprascapular notch. The suprascapular notch in 138 scapulae was classified into six types based on the description by Rengachary. The suprascapular notch was present in 135 (97.8%) scapulae. Type III notch, a symmetrical U shaped notch with nearly parallel lateral margins, was the most prevalent type, appearing in 40 (29%) scapulae. The mean distance from the notch to the supraglenoid tubercle was 28.7 ± 3.8 mm. This varied with the type of notch, being longest in type IV (30.1 ± 1.8 mm) and shortest in type III (27.3 ± 2.3 mm). The mean distance between the posterior rim of the glenoid cavity and the medial wall of the spinoglenoid notch at the base of the scapular spine was found to be 15.8 ± 2.2 mm. Type III notch was the most prevalent, as found in other populations. In a significant number of cases the defined safe zone may not be adequate to eliminate the risk of nerve injury during arthroscopic shoulder procedures, even more so with type I and II notches.
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