Anatomical considerations of the suprascapular nerve in rotator cuff repairs.

James A Tom,Nirav H Amin,Douglas L Cerynik,Addisu Mesfin,Mitesh P Shah,Dan J Lee,Mitra Javandel

doi:10.1155/2014/674179

Abstract

Introduction. When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. Injury to the suprascapular nerve can occur due to the nerve's proximity to the operative field. This study aimed to identify safe margins for avoiding injury to the suprascapular nerve. Materials and Methods. For 20 shoulders in ten cadavers, the distance was measured from the suprascapular notch to the glenoid rim, the articular margin of the rotator cuff footprint, and the lateral border of the acromion. Results. From the suprascapular notch, the suprascapular nerve coursed an average of 3.42 cm to the glenoid rim, 5.34 cm to the articular margin of the rotator cuff footprint, and 6.09 cm to the lateral border of the acromion. Conclusions. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff.

Highlights

When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached
These large tears were repaired with an open technique utilizing soft tissue releases that have been shown to be located in a safe zone that avoids injury to the suprascapular nerve [3]
During the double interval slide, an anterior release is completed, followed by a posterior interval release, which is directed toward the scapular spine between the supraspinatus and infraspinatus until the fat pad that protects the suprascapular nerve is reached

Summary

Introduction

When using the double interval slide technique for arthroscopic repair of chronic large or massive rotator cuff tears, the posterior interval release is directed toward the scapular spine until the fat pad that protects the suprascapular nerve is reached. The results of this study define a safe zone, using anatomic landmarks, to help surgeons avoid iatrogenic injury to the suprascapular nerve when employing the double interval slide technique in arthroscopic repair of the rotator cuff. Adhesions between the soft tissue and the injured rotator cuff can make the reduction of the rotator cuff tendons to bone difficult These large tears were repaired with an open technique utilizing soft tissue releases that have been shown to be located in a safe zone that avoids injury to the suprascapular nerve [3]

Objectives

Methods

Results

Conclusion