XXIV International Symposium on Morphological Sciences, İstanbul, Türkiye, 2 - 06 Eylül 2015, ss.121-122
During drilling of glenoid rim and
anchor insertion to repair SLAP (superior labrum anterior to posterior) lesion,
perforation of glenoid wall might occur. Perforation may lead to injury of the
suprascapular nerve as reported previously. The purpose of this study was to
identify axis of the longest drill depth that passing through 12.00 o’clock in
relation with acromion and coracoid process to avoid the risk of the
suprascapular nerve injury.
Sectra IDS7 multi-touch screen
visualization table, a commercially available 3D reconstructor of CT&MR
images, was used to reconstruct CT images in 3D. 100 shoulder girdles were
included. Coraco-acromial line (CA),
extended between the posterior tip of coracoid process and the antero-lateral
corner of acromion, was drawn to represent coracoacromial arch. Just under and
parallel to CA line, a transvers section
was obtained at 12.00 o’clock. The
longest drill depth without penetrating glenoid wall and its axis according to
CA line were determined in that transverse plan. CA line is divided into three
parts as one third posterior(1/3-P), one third middle(1/3-M) and one third
anterior(1/3-A) to determine practically axis of the longest drill depth.
Totally five different the longest
drill depth axis position was found. 7 of 100 axes were next to the tip of
acromion (1), 4 of 100 axes were in the middle of 1/3-P (2), 44 of 100 axes
were at intersection of 1/3-P and 1/3-M (3), 32 of 100 axes were in the middle
of 1/3-M (4), 13 of 100 axes were at intersection of 1/3-M and 1/3-A (5).
Average of the longest drill depth was measured as 35,7 mm.
In conclusion, the best position to
reach the longest drill depth for anchor insertion is the intersection point of
the one third posterior and two thirds anterior parts of CA line.