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Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Entrapment sites (Figure 25.25): Suprascapular notch.Spinoglenoid notch.Supraspinatus muscle abducts the upper arm up to 30 degrees (deltoid takes over abduction at that point).Infraspinatus muscle assists in external rotation of the upper arm at the shoulder.
Arthroscopic inferior transverse scapular ligament release at the spinoglenoid notch and ganglion cyst decompression using the extra-articular Plancher portal
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Stephanie C. Petterson, Joseph M. Ajdinovich, Kevin D. Plancher
The blunt tip trocar is now utilized to assess the mobility of the suprascapular nerve to ensure adequate release (Figure 41.12a–d). The spinoglenoid notch is then thoroughly inspected for any anatomic variations of the suprascapular nerve (e.g., bifid nerve) or other pathologic findings which may be compressing the nerve (e.g., ganglion cyst) (Figure 41.13a, b). Observation of the released suprascapular nerve with the artery can now be seen hugging tightly as it wraps around the notch and heads medially, giving its 2–4 muscular branches to the infraspinatus (Figure 41.14).
Scapular fractures
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
The scapula is a flat triangular bone, defined by the superior, medial and lateral borders and three angles, including two flat angles: the superior and inferior angles, and the lateral angle, a three-dimensional structure formed by the scapular neck and the glenoid. On the posterior surface of the scapula, the division between the scapular body and neck is marked by the spinoglenoid notch. The anterosuperior surface of the scapular neck bears the origin of the coracoid process. The glenoid has a pear-shaped articular surface with a prominent ring of fibrocartilage at its wider end – the glenoid labrum. The anterior surface of the scapula is concave. The posterior surface of the scapula is divided by a bony ridge – the scapular spine – into the supra- and infraspinous fossae. In its lateral extent, the scapular spine becomes more elevated and ends in a robust bony process – the acromion – which is flattened and curves forward.
Anatomical feasibility study of the infraspinatus muscle neurotization by lower subscapular nerve
Published in Neurological Research, 2023
Aneta Krajcová, Michal Makel, Gautham Ullas, Veronika Němcová, Radek Kaiser
After transection of the skin and removal of the subcutaneous fat, the infraspinatus muscle was dissected, cut along the inferior border of the scapular spine and from the medial edge of the scapula. It was then detached from the floor of the infraspinous fossa and rotated caudo-laterally as in the standard Judet approach [11] for the treatment of scapular body fractures. The entire course of the IB-SSN was dissected from the spinoglenoid notch to the terminal branches (Figures 2, 3). It was then cut as proximally in the spinoglenoid notch as possible and mobilized from the muscle. Then, the circumflex scapular artery was found within the infraspinatus muscle and followed by blunt dissection caudo-laterally outside the scapular body. The length of the distal stump of the IB-SSN was measured to the end of the first branch and it was then rotated inferiorly into the triangular space along the circumflex scapular artery. The infraspinatus muscle was then rotated back to its original position.
Restoration of shoulder external rotation by means of the infraspinatus muscle reinnervation with a radial nerve branch transfer
Published in British Journal of Neurosurgery, 2020
Paulo L. Tavares, Mario G. Siqueira, Roberto S. Martins, Monise Zaccariotto, Luciano Foroni, Carlos O. Heise, Davi Solla
Muscles relating to the approach are demonstrated in Figure 2. Dissecting in the posterior suprascapular area the supraspinatus and infraspinatus branches of the suprascapular nerve were separated, after opening the superior transverse scapular ligament (Figure 3), and the infraspinatus branch was dissected in the supraspinatus fossa until the spinoglenoid notch. After lateral and superior displacement of the deltoid muscle, the infraspinatus muscle was partially detached from the scapular spine and a layer between the scapula and the infraspinatus fascia was developed, from the most lateral portion of the inferior border of the spine of the scapula and from the surface of the scapula itself. The infraspinatus muscle originates from the medial two-thirds of the posterior surface of the scapula, below the spine of the scapula, which makes it simpler to displace the muscle posteriorly and inferiorly, given its loose adhesion to the most lateral part of the scapula. The infraspinatus branch of the suprascapular nerve was identified in the region of the spinoglenoid notch, next to the suprascapular artery. Once identified, the nerve was dissected in a proximal direction, as far as the point at which it goes round the side of the spine of the scapula and enters the infraspinous fossa (Figure 4).
Suprascapular nerve entrapment in young kayaker: a case report
Published in The Physician and Sportsmedicine, 2020
Christa L. LiBrizzi, Jorge L. Rojas, Nicholas C. Bontrager, Uma Srikumaran, Edward G. McFarland
Because of persistent pain despite of 4 months of non-operative treatment, the patient underwent shoulder arthroscopy with al-arthroscopic SNN decompression through the subacromial space [11]. Arthroscopic evaluation of the joint revealed no labrum tears, rotator cuff lesions or signs of shoulder instability. Arthroscopic SSN decompression began with a decompression of the area above the subscapularis and the medial coracoid including the described ganglion cyst at this location. The transverse scapular ligament (STSL) was then exposed, revealing an ossified STSL that appeared to be compressing the SSN. The STSL was then released, and the SSN appeared decompressed at the suprascapular notch. The spinoglenoid notch area was also inspected and some ligamentous tissue that may have been impinging on the nerve at this level was resected and decompressed. There were no complications and the patient was discharged to home in a sling. After two weeks the sling was discontinued, and the patient was allowed passive shoulder motion for 2 weeks followed by unlimited active range of motion. No strength training was allowed until after 2 months post-operatively with a focus on strengthening the rotator cuff muscles. The patient was pain free and returned to kayaking 11 months post-operatively.