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.