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ANATOMICAL CHARACTERISTICS OF SUBSCAPULARIS INSERTION IN VIETNAMESE ADULTS RELATED TO SURGERY
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Abstract
Background: Arthroscopic subscapularis tendon repair surgery is very important in restoring anatomy and achieving good function of the shoulder joint. There are many empirical studies showing the effectiveness of single-row suture using modified Mason-Allen technique. Currently, there are not many studies of the anatomy of the subscapularis tendon insertion to the lesser tuberosity. These studies have mainly focused on size and shape of the attachment site. They lack the identification of relationships between the features of the attachment site and between these features and important anatomical landmarks that can be applied in clinical practice to help the surgeon determine the exact location to place anchors. Materials and Methods: Descriptive study consisted of 20 shoulders of fresh cadavers with an average age of 63.2, not accompanied by rotator cuff lesions. These specimens were dissected and to reveal the subscapularis and their insertions in a consistent procedure. Anatomical features of subscapularis insertion were marked and scanned by a 3D scanner. Image data was extracted and analyzed by specialized 3D image processing software. Results: The subscapularis tendon attachment site to the lesser tuberosity expanded and attached mainly to the upper two-third and gradually narrows inferiorly. The superior part of the attachment site followed the boundary between the medial edge of the biceps and the lateral border of the lesser tuberosity. The inferior part of the attachment site still followed the lateral border of the lesser tuberosity and gradually moved medially. The distances from the most superior-medial point, superior-lateral point and inferior point to the articular cartilage edge were 4.66 ± 1.02mm, 18.53 ± 2.74mm, 16.74 ± 2.97mm, respectively. The distances from the most superior-lateral point to the most superior-medial point and inferior point were 14.92 ± 2.81mm and 24.71±2.47mm, respectively. Conclusion: Some anatomical features of the subscapularis insertion may help determine the locations of the anchors in subscapularis tendon repair surgery more accurately and nearly anatomically similar to the original insertion.
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Keywords
Anatomy, subscapularis tendon attachment site, lesser tuberosity, Vietnamese adults
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