Sibel ÇIRPAN, Goksin Nilufer YONGUC, Mustafa GÜVENÇER

Processus Coracoideus ve Cavitas Glenoidalis’in Cerrahi Yaklaşımlar Açısından Morfometrik Analizi: Anatomik Çalışma

GİRİŞ ve AMAÇ: Tekrarlayan omuz dislokasyonlarının cerrahi tedavisinde doğal glenohumeral anatomiyi tekrar oluşturmak için, processus coracoideus (PC) transferi işlemleri kullanılmaktadır. Bu çalışmanın amacı PC ve cavitas glenoidalis (CG) boyutlarını ölçmek ve sonuçlar arasındaki korelasyonu incelemektir. YÖNTEM ve GEREÇLER: Bu çalışmada Dokuz Eylül Üniversitesi Anatomi Anabilim Dalı Laboratuvarı’nda yer alan 62 adet yetişkin insana ait kuru kemik scapula, makroskopik olarak incelendi. CG’in superoinferior yüksekliği ve en geniş anteroposterior çapı, PC’in uzunluğu, kök yüksekliği, ucunun ve kökünün genişliği, ve PC’in ucu ile CG’in tuberculum supraglenoidale arasındaki uzaklıklar 0.01mm’ye duyarlı dijital kumpas kullanılarak ölçüldü. BULGULAR: CG’in ortalama uzunluğu ve genişliği, PC’in kök genişliği, kök yüksekliği, uç genişliği ve uzunluğu sırasıyla 37.27 ± 3.40 mm, 26.25 ± 3.04 mm, 13.98 ± 1.69 mm, 18.59 ± 2.55 mm, 13.95 ± 1.73 mm, 42.36 ± 4.28 mm ölçüldü. CG’in tuberculum supraglenoidale’si ile PC’un ucu arasındaki uzaklık 27.56 ± 3.75 mm ölçüldü. TARTIŞMA ve SONUÇ: PC’un boyutları coğrafi bölge farklılıklarına bağlı değişmektedir.

Morphometric Analysis of Coracoid Process And Glenoid Cavity In Terms of Surgical Approaches: An Anatomical Study

INTRODUCTION: In order to treat the recurrent shoulderdislocations surgically, the coracoid process (CP) transferprocedures are used to restore the native glenohumeralanatomy. The aim of this study is to measure the dimensions ofthe CP and the glenoid cavity (GC) and to evaluate thecorrelation between their measurements.METHODS: Sixty two adult dried human scapulae belongingto the Anatomy Department Laboratory of Dokuz EylulUniversity School of Medicine were examinedmacroscopically. The study parameters measured by using adigital caliper sensitive to 0.01 mm were as follows: the CP(length, heigth at the root, width at the tip and at the root), theGC (the superoinferior height and the widest antero-posteriordiameter) and from the CP tip to the supraglenoid tubercle ofGC.RESULTS: The mean length and width of the GC and rootwidth, root height, tip width and length of the CP weremeasured as 37.27 ± 3.40 mm, 26.25 ± 3.04 mm, 13.98 ± 1.69mm, 18.59 ± 2.55 mm, 13.95 ± 1.73 mm, 42.36 ± 4.28 mm,respectively. The distance between supraglenoid tubercle ofGC and CP tip was measured as 27.56 ± 3.75 mm.DISCUSSION AND CONCLUSION: The dimensions of theCP may differ according to geographical differences.

PDF

___

Sahajpal DT, Zuckerman JD. Chronic glenohumeral dislocation. J Am Acad Orthop Surg 2008;16(7):385-98.
Boileau P, Villalba M, Hery JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 2006;88(8):1755-63.
Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill- Sachs lesion. Arthroscopy 2000;16(7):677-94.
Gartsman GM, Roddey TS, Hammerman SM. Arthroscopic treatment of anterior-inferior glenohumeral instability: two to five-year followup. J Bone Joint Surg Am 2000;82(7):991-1003.
Lo IK, Parten PM, Burkhart SS. The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy 2004;20(2):169-74.
Churchill RS, Brems JJ, Kotschi H. Glenoid size, inclination, and version: an anatomic study. J Shoulder Elbow Surg 2001;10(4):327-32.
Hovelius L, Akermark C, Albrektsson B, et al. Bristow-Latarjet procedure for recurrent anterior dislocation of the shoulder: a 2-5 year follow- up study on the results of 112 cases. Acta Orthop Scand 1983;54(2):284-90.
Itoi E, Lee SB, Berglund LJ, Berge LL, An KN. The effect of a glenoid defect on anteroinferior stability of the shoulder after Bankart repair: a cadaveric study. J Bone Joint Surg Am 2000;82(1):35-46.
Ikemoto RY, Murachovsky J, Strose E, Nascimento LG, Bueno RS, Almeida LH. Recurrent shoulder dislocation: aspects between the first episode and surgical treatment. Rev Bras Ortop 2009;44(6):524-8.
Latarjet M. [Treatment of recurrent dislocation of the shoulder]. Lyon Chir 1954;49(8):994-7.
Dumont GD, Fogerty S, Rosso C, Lafosse L. The arthroscopic Latarjet procedure for anterior shoulder instability: 5-year minimum follow-up. Am J Sports Med 2014; 42:2560–6.
Giles JW, Degen RM, Johnson JA, Athwal GS. The Bristow and Latarjet procedures: why these techniques should not be considered synonymous. J Bone Joint Surg Am 2014; 96:1340–8.
Yamamoto N, Muraki T, An KN, Sperling JW, Cofield RH, Ltoi E, et al. The stabilizing mechanism of the Latarjet procedure: a cadaveric study. J Bone Joint Surg Am 2013; 95:1390–7.
Kleist KD, Freehill MQ, Hamilton L, Buss DD, Fritts H. Computed tomography analysis of the coracoid process and anatomic structures of the shoulder after arthroscopic coracoid decompression: a cadaveric study. J Shoulder Elbow Surg 2007;16(2):245–50.
1. 15.MacLennon RN. Interrater reliability with SPSS for Windows 5.0. The American Statistician 1993; 47:292-6.
Beeson M. Complications of shoulder dislocation. Am J Emerg Med 1999; 17:288-95.
Bernageau J. [Imaging of the shoulder in orthopedic pathology]. Rev Prat 1990; 40:983-92.
Hovelius L, Sandstr€om B, Sundgren K, Saeb€o M. One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study Idclinical results. J Shoulder Elbow Surg 2004; 13:509-16.
Kahn J, Mehta S. The role of post-reduction radiographs after shoulder dislocation. J Emerg Med 2007; 33:169-73.
Allain J, Goutallier D, Glorion C. Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 1998; 80:841-52.
Beran MC, Donaldson CT, Bishop JY. Treatment of chronic glenoid defects in the setting of recurrent anterior shoulder instability: a systematic review. J Shoulder Elbow Surg 2010; 13:1-12.
Singer GC, Kirkland PM, Emery RJ. Coracoid transposition for recurrent anterior instability of the shoulder. A 20-year follow-up study. J Bone Joint Surg Br 1995; 77:73-6.
2. 23.Lynch JR, Clinton JM, Dewing CB, WarmeWJ, Matsen FA 3rd. Treatment of osseous defects associated with anterior shoulder instability. J Shoulder Elbow Surg 2009;18(2): 317-28.
Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richardsm DP. Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy 2007;23(10):1033-1041.
De Beer JF, Roberts C. Glenoid bone defects: open Latarjet with congruent arc modification. Orthop Clin North Am 2010;41(3):407-15.
Bachy M, Lapner PL, Goutallier D, Allain J, Hernigou P, Bénichou J et al. Coracoid process x-ray investigation before Latarjet procedure: a radioanatomic study. J Shoulder Elbow Surg 2013;22(12): e10-4.
Dolan CM, Hariri S, Hart ND, McAdams TR. An anatomic study of the coracoid process as it relates to bone transfer procedures. J Shoulder Elbow Surg 2011;20(3):497-501.
Salzmann GM, Paul J, Sandmann GH, Imhoff AB, Schottle PB. The coracoidal insertion of the coracoclavicular ligaments: an anatomic study. Am J Sports Med 2008;25(36):2392-7.
Bueno RS, Ikemoto RY, Nascimento LG, Almeida LH, Strose E, Murachovsky J. Correlation of coracoid thickness and glenoid width: an anatomic morphometric analysis. Am J Sports Med 2012;40(7):1664-7.
Gallino M, Santamaria E, Doro T. Anthropometry of the scapula: clinical and surgical considerations. J Shoulder Elbow Surg 1998; 7(3):284–91.
Rios CG, Arciero RA, Mazzocca AD. Anatomy of the clavicle and coracoid process for reconstruction of the coracoclavicular ligaments. Am J Sports Med 2007; 35:811-7.
Lian J, Dong L, Zhao Y, Sun J, Zhang W, Gao C. Anatomical study of the coracoid process in Mongolian male cadavers using the Latarjet procedure.J Orthop Surg Res 2016; 11: 126.
Kavita P, Jaskaran S. Morphology of coracoıd process and glenoıd cavıty ın adult human scapulae.Int.J.Anal.,Pharm. Biomed. Sci. 2013; 2 (2):19-22.
Coskun N, Karaali K, Can Cevikol C, Bahadir M, Demirel BM, Sindel M. Anatomical basics and variations of the scapula in Turkish adults. Saudi Med J 2006; 27 (9): 1320-5.
Cezayir E, Ates Y, Ersoy M, Tekdemir I. Morphometric anatomy of the acromion and the coracoacromial arch. Acta Orthop Traumatol Turc1995; 29:224-6.
Imma II, Nizlan NM, Ezamin AR, Yusoff S, Shukur MH. Coracoid Process Morphology using 3D-CT Imaging in a Malaysian Population. Malaysian Orthopaedic Journal 2017;11(2):30-5.
Yamamoto N, Muraki T, Sperling JW, Steinmann SP, Cofield RH, Itoi E et al. Stabilizing mechanism in bone-grafting of a large glenoid defect. J Bone Joint Surg Am2010;92(11):2059-66.