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Morphometric analysis of glenoid fossa of scapula.

INTRODUCTION: MATERIAL AND METHOD: Sixty adult scapulae of unknown sex were taken from the Department of Anatomy, Government Medical College, Jammu. Dry adult scapulae of either sex, taken for study were free from physical deformity or abrasion and were complete in all aspects i.e., the upper and lower ends were intact, so as to give the correct measurements. Those scapulae which were having any pathology of the glenoid region e. g. old healed fracture were excluded from the study. These scapulae were labelled from 1 to 60 with suffix R (right) or L (Left) for right and left side respectively. The shape of the glenoid fossa (Cavity) or head of the scapula was noted in all. The shape was determined by either the presence of a (Distinct or indistinct) notch on the upper and anterior part of glenoidal rim or its absence. Morphometry of the glenoid cavity was done by taking two measurements with the help of a Vernier Calliper which were:

1. Maximum Superior-Inferior glenoid diameter.

2. Maximum Anterior-Posterior glenoid diameter.

OBSERVATION: The following observations were made from the morphological study of glenoid fossa of sixty scapulae obtained from the department of Anatomy Government Medical College Jammu:

1. Side of scapula-Out of sixty scapulae, thirty were of the right side and thirty were of the left side. (Fig-1).

2. Shape of the glenoid cavity-The glenoid cavity was observed to be of following shapes based on the presence of a notch on anterior glenoid rim:

a. Inverted comma shaped--The glenoid cavity has a distinct notch as shown in figure-2

b. Pear shaped or Tear drop shaped-The glenoid cavity was having an indistinct notch as shown in figure-3.

c. Ovoid or oval or Round shaped-The glenoid cavity had no notch as shown in figure-4.

d. The results were compared on the two sides (Right and left) in all the scapulae.

e. It was observed that in 38% the glenoid cavity was inverted comma shaped i.e. seen in 12 scapulae on the right side and 11 scapulae on the left side. Pear shaped glenoid cavity was seen in 42% of scapulae i. e. 13 on the right side and 12 on the left side. Ovoid shape of the glenoid cavity was seen in 20% of scapulae i.e. 5 on right side and 7 on the left side (Table-1) (Pie chart).

3. Morphometry of the glenoid fossa-Two diameters were taken:

a. Superior-Inferior glenoid diameter -Maximum Superior--Inferior length of the glenoid cavity was measured with the help of Vernier Calliper. Mean, Range and Standard Deviation of this diameter calculated (in cms) on right and left side. (Table-2) It was observed that Mean of the Superior-Inferior diameter was 3.49 cm on the Right side (Range 2.6 cm-4.3cm) and 3.30 cm on the Left side (Range 2.6cm-4) The Standard deviation on the Right side was 0.440 and on the Left side was 0.330.

b. Anterio-Posterior glenoid diameter-Maximum Anterio-Posterior length of the glenoid cavity was measured with the help of Vernier Calliper. Mean, Range and Standard Deviation of this diameter calculated (in cms) on right and left side. (Table-3). The Mean of the Antero-Posterior diameter of glenoid cavity was 2.31 cm on the Right side (Range 1.8 cm -3cm) and 2.06 cm on the Left side (Range 1.4cm-2.5cm) The Standard deviation on the Right side was 0. 310 and on the Left side was 0.300.

DISCUSSION: The present study has been undertaken on a series of 60 adult scapulae (R: L=30:30) obtained from the Department of Anatomy, Government Medical College, Jammu. The shape of the glenoid cavity and its various morphometric parameters were taken and statistical indices worked out. The shape of the glenoid cavity was due to presence of a notch on the upper and anterior wall of glenoid cavity. This notch is consequently a common finding and not a rare anatomical variant. When the notch is present, the shape of the glenoid cavity can be described as pear shaped or inverted comma, when absent the cavity is round or oval shaped. Glenoid labrum in the area of the notch is not fixed to the bony margins of the glenoid cavity but bridges the notch itself. Such an attachment of the labrum could make the shoulder joint less resistant to the dislocating forces. Earlier Prescher. (4) had studied this parameter and classified shape of glenoid cavity into pear and round shaped as one with and without a distinct notch. Coskun et al. (5) classified the shapes of glenoid cavity as pear and round shape. Mamatha et al. (6) observed the presence of glenoid notch, i.e. both distinct and indistinct as 80% on right side and 76% on left side. Moreover, occurrence of oval on right side was 20% and left side was 24%. Results of present study are in accordance with those of Mamatha et al, (6) as in present study glenoid cavity was categorised as inverted comma, pear and round shaped (Table-4). The dimensions of the glenoid fossa provide important information for designing and fitting of glenoid component for shoulder arthroplasty. The mean superior-inferior diameter of scapula was found to be 3.40 [+ or -] 0.38cm, (Range=2.6-4.3), with mean of 3.49 [+ or -] 0.432cm (Range=2.6-4.3) on right side; and 3.30 [+ or -] 0.33 as mean (Range=2.6-4cm) on left side. (Table-5) Ozer et al, (7) measured the superior-inferior diameter of male and female glenoid cavities separately. The Mean and Standard Deviation of male glenoid was 3.87 [+ or -] 0.27cm while that of female glenoid was 3.37 [+ or -] 0.30cm respectively. Mamatha et al. (6) also measured the superior-inferior diameter. The results on right side varied from 2.5cm to 4.2cm with an average of 3.36cm and Standard Deviation of 0.28. On the left side the superior-inferior diameter varied from 2.6 to 4cm with a Mean and Standard Deviation of 3.39cm and 0.28cm respectively. Results of present study are similar to Cho et al. (8) and Mallon et al. (9)

The Mean antero-posterior glenoid diameter of scapula was found to be 2.19 [+ or -] 0.29 cm (Range=1.4-3cm) with Mean of 2.31 [+ or -] 0.3 cm (Range=1.8-3 cm) on right side; and 2.06 [+ or -] 0.295 cm as Mean (Range=1.4-2.5cm) on left side (Table-6). Earlier Von Schroeder et al. (10) Piyawinijwong et al. (11) Coskun et al. (5) and Burke, (12) also measured antero-posterior diameter of glenoid cavity of scapula. Results of present study are more in accordance with those of Coskun et al, (5) and results of other studies are slightly higher than the present study.

SUMMARY: Anatomical considerations of variations of glenoid cavity are crucial for understanding specific abnormalities of shoulder joint like glenohumeral instability, shoulder dislocation, rotator cuff injuries, Bankart, s lesion, osteochondral defects etc. The dimensions of the glenoid fossa provide important information for designing and fitting of glenoid component for shoulder arthroplasty. The present study was undertaken to furnish morphological and morphometric data providing an Anatomical baseline, during surgical and arthroscopic procedures on shoulder joint. After compilation of the morphometric parameters of the glenoid fossa of scapulae we were of the conclusion that all our values were slightly less than those of the work done by other authors.

DOI: 10.14260/jemds/2015/1129

REFERENCES:

(1.) Breathnach A S Frazers; Anatomy of the human skeleton 6th e d London J and A Churchill Ltd 1965; pp 63-70.

(2.) Prescher A and Klumpen T.; The glenoid notch and its relation to the shape of glenoid cavity of the scapula J Anat 1997; 190: 457-460.

(3.) Watch G Badet R Boulahia A Khoury A; Morphologic study of the glenoid in primary glenohumeral osteoarthritis The Journal of Arthroplasty 1999; 14(6): 756-760.

(4.) Prescher A.; Anatomical basics, variations and degenerative changes of the shoulder joint and shoulder girdle. Eur J Radiol 2000; 35(2); 88-102.

(5.) Coskun N, Karaali K, Cevikol C, Demirel B M and Sindel M.; Anatomical basics and variations of the scapula in Turkish adults. Saudi Med J 2006; 27(9): 1320-1325.

(6.) Mamatha T, Pai S R, Murlimanju B V, Kalthur SG, Pai M M and Kumar B.; Morphometry of glenoid cavity. Online J Health Allied Scs 2011; 10 (3): 7.

(7.) Ozer I, Katayama K, Sagir M and Gulec E.; Sex determination using the scapula in medieval skeletons from East Anatolia. Coll Anthropol 2006; 30(2): 415-419.

(8.) Cho B P and Kang H S.; Articular facets of the coracoclavicular joints in Koreans. Acta Anat (Basel) 1998; 163 (1): 56-62.

(9.) Mallon W J, Brown H R, Vogler J B 3rd and Martinez S.; Radiographic and geometric anatomy of the scapula. Clin Orthop Relat Res 1992; (227): 142-154.

(10.) Von Schroeder H P, Kuiper S D and Botte M J. Osseous anatomy of the scapula. Clin Ortho Relat Res 2001; (383): 131-139.

(11.) Piyawinijwong S, Sirisathira N and Chuncharunee A. The scapula: Osseous Dimensions and Gender Dimorphism in Thais. Siriraj Hosp Gaz 2004; 56(7): 356-365.

(12.) Burke R M. Can we estimate stature from the scapula? A test considering sex and ancestry, 2008; B S University of Idaho.

Sangeeta Gupta [1], Rachna Magotra [2], Manmeet Kour [3]

AUTHORS:

[1.] Sangeeta Gupta

[2.] Rachna Magotra

[3.] Manmeet Kour

PARTICULARS OF CONTRIBUTORS:

[1.] Associate Professor, Department of Anatomy, Government Medical College, Jammu.

[2.] Assistant Professor, Department of Anatomy, Government Medical College, Jammu.

[3.] Assistant Surgeon, Department of Anatomy, J & K Health Services.

FINANCIAL OR OTHER COMPETING INTERESTS: None

NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:

Dr. Rachna Magotra, 242/7, Channi, Himmat-180015, Jammu.

E-mail: drmagotrarachna@gmail.com

Date of Submission: 13/05/2015. Date of Peer Review: 14/05/2015. Date of Acceptance: 27/05/2015. Date of Publishing: 02/06/2015.

Table 1: Shape of Glenoid Cavity

Sl. No.       Shape         Right     Left     Percentage
                           Glenoid   Glenoid

1         Inverted Comma     12        11          38
2              Pear          13        12          42
3             Ovoid           5         7          20

Table 2: Statistical Measurement of Superior-Inferior
Diameter of Glenoid Cavity (in cms.)

Sl. No.   Parameters    Right    Left    Total Avg.

1            Mean       3.49     3.30       3.40
2           Range      2.6-4.3   2.6-4    2.6-4.3
3         Std. Dev.     0.440    0.330     0.385

Table - 3 Statistical Measurement of Anterio-posterior
Diameter of Glenoid Cavity (in cms.)

Sl. No.   Parameters   Right    Left     Total Avg.

1            Mean      2.31     2.06        2.19
2           Range      1.8-3   1.4-2.5     1.4-3
3         Std. Dev.    0.310    0.300      0.305

Table 4: Showing comparison of Shape of Glenoid Cavity

                  Inverted           Pear       Ovoid/Round
                Comma/Distinct
                    Notch

Authors         Right    Left    Right   Left   Right   Left

Prescher         55%                             45%
Coskun et al      -               28%            72%
Mamatha          34%      33%     46%    43%     20%    24%
Present          40%      37%     43%    40%     17%    23%

Table 5: Showing Comparison of Superior-Inferior
Diameter of Glenoid Cavity

Authors                    Race       Mean(cm)   Range(cm)    SD

Mallon et al                            3.5                  0.4
Von Schoreder et al      Canadian       3.6         --       0.4
Piyawinijwong et al        Thai         3.36      2.7-4.3     --
Cho et al                 Korean        3.52        --        --
Burke                       --          3.9       3.2-4.8    0.35
Coskum                   Turkish        3.36        --       0.3
Present study          North Indian     3.40      2.6-4.3    0.38

Table 6: Showing comparison of Antero- posterior
diameter of Glenoid Cavity

Authors                    Race       Mean(cm)   Range(cm)    SD

Von Schroeder et al      Canadian       2.9       2.5-3.4    0.3
Coskum et al             Turkish        2.4         --       0.25
Piyawinijwong et al        Thai         2.7       2.1-3.3    0.31
Burke                       --          2.81      2.1-4.6    0.31
Present Study          North Indian     2.19      1.4-3.0    0.29
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Title Annotation:ORIGINAL ARTICLE
Author:Gupta, Sangeeta; Magotra, Rachna; Kour, Manmeet
Publication:Journal of Evolution of Medical and Dental Sciences
Date:Jun 4, 2015
Words:1955
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