Scapular fractures
Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth in Musculoskeletal Trauma in the Elderly, 2016
A Judet posterior approach provides excellent exposure of the entire infraspinous fossa, the lateral and medial borders of the scapula, the anatomical and surgical scapular necks and the posterior and inferior rims of the glenoid. The Judet posterior approach is indicated as a universal exposure in fractures of the scapular body, scapular neck and the inferior glenoid. In some cases it is possible to make only medial and lateral para-muscular windows without mobilizing the infraspinatus. On the lateral side, it is sufficient to detach the infraspinatus from the lateral border of the scapula only in the required field; on the medial side it is typically released in the spino-medial angle. The exposure depends on the fracture pattern and the surgeon’s experience. Patients without mobilization of the infraspinatus muscle experience less postoperative pain and restoration of the range of motion is much faster.
Arthroscopic inferior transverse scapular ligament release at the spinoglenoid notch and ganglion cyst decompression using the extra-articular Plancher portal
Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss in Atlas of Advanced Shoulder Arthroscopy, 2017
Abnormal signal intensity within the infraspinatus muscle can indicate suprascapular nerve compression at the spinoglenoid notch. Some patients will demonstrate increased signal intensity on T2 fast spin echo, with fat saturation with a normal muscle mass implying subacute denervation of the nerve caused by neurogenic edema. Chronic denervation will be best appreciated on T1 spin echo sequences, with increased signal intensity within the muscle mass indicating muscle atrophy with fatty infiltration (Figure 41.7). Newer modalities such as ultrasound may also be helpful to identify ganglion cysts as well as to aid visualization during an ultrasound-guided aspiration of the ganglion cyst.
Diseases of the Peripheral Nerve and Mononeuropathies
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
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.
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).
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.
The effect of experimental shoulder pain on contralateral muscle force and activation
Published in Physiotherapy Theory and Practice, 2021
Scott K. Stackhouse, Brett A. Sweitzer, Philip W. McClure
In conclusion, experimental shoulder pain of moderate intensity has only a small effect on contralateral infraspinatus muscle force and does not have a significant effect on contralateral infraspinatus muscle VA. There also may be a subset for whom a contralateral shoulder muscle response is more significant and; therefore, may be important to index or compare strength bilaterally throughout the rehabilitation to capture the bilateral effect as pain resolves. The results of this study should be interpreted with caution, due to the lack of a control injection group, and should be used to spur further investigations into bilateral force and VA effects in experimental pain and clinical conditions.
Related Knowledge Centers
- Greater Tubercle
- Muscle
- Shoulder Joint
- Teres Major Muscle
- Infraspinous Fossa
- Rotator Cuff
- Scapula
- Humerus
- Infraspinous Fascia
- Teres Minor Muscle