Abstract
BackgroundThe anatomical variation of the coracoglenoid space has the potential to influence the stability of scapular neck fractures. This paper aimed to investigate the mechanical mechanism underlying the influence of different coracoglenoid space types on scapular neck fractures by morphometric analysis and biomechanical experiments.MethodsThe morphology of 68 dried scapulae (left: 36; right: 32) was studied. Two variables, the length of the coracoglenoid distance (CGD) and the coracoglenoid notch (CGN), were measured. The distribution of CGN/CGD × 100% was used to identify the morphology of the coracoglenoid space. Each specimen was tested for failure under static axial compression loading. The average failure load, stiffness, and energy were calculated.ResultsTwo coracoglenoid space types were identified. The incidence of Type I (‘‘hook’’ shape) was 53%, and that of Type II (‘‘square bracket’’ shape) was 47%. The CGD and CGN were significantly higher for type I than type II (13.81 ± 0.74 mm vs. 11.50 ± 1.03 mm, P < 0.05; 4.74 ± 0.45 mm vs. 2.61 ± 0.45 mm, P < 0.05). The average maximum failure load of the two types was 1270.82 ± 318.85 N and 1529.18 ± 467.29 N, respectively (P = 0.011). The stiffness and energy were significantly higher for type II than type I (896.75 ± 281.14 N/mm vs. 692.91 ± 217.95 N/mm, P = 0.001; 2100.38 ± 649.54 N × mm vs. 1712.71 ± 626.02 N × mm, P = 0.015).ConclusionsThere was great interindividual variation in the anatomical morphology of the coracoglenoid space. Type I (hook-like) spaces bore lower forces, were less stiff, and bore less energy, which may constitute an anatomical predisposition to scapular neck fractures.
Highlights
The anatomical variation of the coracoglenoid space has the potential to influence the stability of scapular neck fractures
Scapular neck fractures are caused by high-energy impact transmitted by an external object or the humeral head [1, 5] and account for approximately 5–8% of all scapular fractures [6, 7]
Scapular neck fractures have been an object of research since the 1840s [10]
Summary
The anatomical variation of the coracoglenoid space has the potential to influence the stability of scapular neck fractures. The main types include anatomical neck fracture, surgical neck fracture, and transspious neck fracture [6]. The types of these fractures are usually defined by surgeons according to the relationship between the fracture line and the passage through the coracoglenoid space [6]. Radiological studies demonstrated that the line of anatomical neck fractures crossed the scapular neck and passed through superiorly between the superior pole of the glenoid fossa and the base of the coracoid fossa [6, 11, 12]. Detailed knowledge of the variation of this space is crucial for understanding scapular neck fractures
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