Degenerative changes of the coracoacromial(CA) arch were investigated in 114 dry scapulae from 57(male 35 female 22) Korean cadavers The cadavers were of individuals who had ranged In age from 18 to 97 years(average age of 67) The types of degenerative changes could be classified into facet and spur types Degenerative changes occured in 51.9%(bilateral 29.6% unilateral 22. 2%) of the individuals with both acromions intact and in 41.4% of the scapulae with intact acromion The frequency of degenerative changes was higher m the males but there was no significant difference between the sides Among the scapulae with degenerative changes m the CA arch 43.5% showed single facet type degeneration and both single spur-type and compound degenerative changes occurred in 28.3% respectively of the total number of degenerative changes facet-type degeneration was the most common(67.4%) followed by spur-type on the acromion(34.8%) and spur-type on the coracoid process(28.3%) Frequencies of degenerative changes of the CA arch according to age bracket were 0.0% for 10~39 47.5% for 40~69 and 44.3% for 70~99 Thus it was confirmed that the CA arch is most likely to develop degenerative changes after 40 years of age Profile shapes of the acromion were classified into curved(86.5%) hooked(8.1%) and flat(5.4%) types The incidence of degenerative changes of the CA arch was highest in the curved acromion but the rate of occurrence of the degenerative changes was highest in the hooked acrormion Compared to the normal condition the morphometric characteristics of the scapulae showing degenerative changes of the CA arch were as follows 1) The acromion is wider and the slope of the scapular spine is smaller 2) the angle between the root and the horizontal part of the coracoid process is smaller 3) most diameters of the acromial articular surface and the glenoid cavity are greater.
Acromion ; Cadaver ; Female ; Glenoid Cavity ; Humans ; Incidence ; Male ; Scapula ; Spine

Arthroscopy is recognized as an important adjunct in treatment of intra-articular fractures. The author reports on successful treatment of a displaced transverse glenoid cavity fracture, reduced and fixed with arthroscopic assist, using two cannulated screws perpendicular to the fracture surface, in a patient with frail chest. One screw passed through the Neviaser portal, and the other screw passed through the base of the coracoid process. Arthroscopy assisted reduction and 2 cannulated screw fixation through the Neviaser portal and coracoid base appears to be a good method for treatment of transverse glenoid fractures.
Arthroscopy* ; Glenoid Cavity ; Humans ; Intra-Articular Fractures ; Methods ; Thorax

We, herein, present a patient with no history of trauma who developed shoulder pain after undergoing low-voltage electric shock. According to the computed tomography, there was a multi-segmental fracture that extended into the glenoid cavity of the left scapula. A good outcome was obtained after open reduction and internal fixation. Emergency physicians should be aware of the possibility of scapular fracture extending into the glenoid cavity, especially in patients with shoulder pain after electrical injury.
Electric Injuries ; Emergencies ; Glenoid Cavity* ; Humans ; Scapula ; Shock* ; Shoulder Pain

Arthroscopic treatment of shoulder instability involves two techniques mainly, transglenoid suture technique and anterior anchoring system. However, anterior anchoring system has some disadvantages such as limited indication, high cost, technical difficulty and incapability to suture or reconstruct for all types of Bankart lesion. Disadvantages of transglenoid suture techniques are indirect suture tie, bump effect and possibility of the suprascapular nerve injury. The authors use modified transglenoid suture technique (Rhees method) for shoulder instability involving Bankart lesion, type II SLAP lesion and capsular laxity. The purpose of this study is to accurately describe the relationship between the major neurovascular structures and the pinning sites used in transglenoid suture technique (Rhees method). Placement of two or three arthroscopic Beath pinning sites was simulated in four fresh cadaveric shoulder specimens by placing Steinman pins into the glenoid rim under open field. The specimens were then dissected and the relationship of the pinning sites to the suprascapular nerve and suprascapular artery were recorded. In Bankart lesion repair, safe zone of pinning sites were 2 and 5 oclock in two portals in right shoulder, safe zone of pinning sites were 7 and 10 oclock in two portals in left shoulder. Safe direction of pinning was as possible as inferomedial side in scapula. In type II SLAP repair, safe zone of pinning sites were 2 oclock and just above 2 oclock of glenoid in right shoulder and 10 oclock and just above 10 oclock of glenoid in left shoulder. Safe direction of pinning was pararell to glenoid cavity and slightly superior in horizontal plane. From this study, these sites and directions appeared to be safe. Proper pinning depends on careful attention to the topographical anatomy about the shoulder.
Arteries ; Cadaver* ; Glenoid Cavity ; Scapula ; Shoulder ; Suture Techniques* ; Sutures*

Arthroscopy is recognized as an important adjunct in treatment of intra-articular fractures. The author reports on successful treatment of a displaced transverse glenoid cavity fracture, reduced and fixed with arthroscopic assist, using two cannulated screws perpendicular to the fracture surface, in a patient with frail chest. One screw passed through the Neviaser portal, and the other screw passed through the base of the coracoid process. Arthroscopy assisted reduction and 2 cannulated screw fixation through the Neviaser portal and coracoid base appears to be a good method for treatment of transverse glenoid fractures.
Arthroscopy ; Glenoid Cavity ; Humans ; Intra-Articular Fractures ; Methods ; Thorax

The present study was performed to provide an anatomical basis of the coracoacromial (CA) arch and the articular surfaces of the scapula which can be applied to the diagnosis and treatment of some common shoulder problems. The standard dimensions and the range of variation of the CA arch, the acromial articular surface and the glenoid cavity were investigated in 114 dry scapulae obtained from 57 (male, 35 ; female, 22) Korean cadavers ranging in age from 18 to 97 years (average age of 67). The results were as follows : 1. The length (46.3mm), width(25.2mm), thickness (8.2mm) and height (4.5mm) of the acromion were measured. The length, width and thickness were significantly larger in the males. The slope of the acromion was 51.5°, and the slope of the scapular spine was 118.5°. 2. The height (13.5mm), slope of the root (138.4°) and the horizontal part (25.3°) of the coracoid process, and the angle between the root and the horizontal part (106.6°) were measured. There were no significant differences between sexes and sides in all morphometric values related to the coracoid process. 3. The length (67.6mm) and height (24.7mm) of the CA arch, the height of the CA ligament from the supraglenoid tubercle (13.1mm), and length of the CA ligament (27.6mm) were measured. Both the length and height of the CA arch and the length of the CA ligament were significantly larger in the males. The slope and anterior and posterior angles of the CA arch were 16.8°, 42.2°, and 34.7°, respectively. 4. The long (13.8mm) and short (8.0mm) diameters of the acromial articular surface were measured, and both diameters were significantly longer in the males. The acromial articular surface was 8.4mm away from the tip of the acromion and extended 1.4mm inferiorly below the inferior surface of the acromion. 5. The long (34.8mm) diameter, and superior (15.0mm), middle (19.5mm), and inferior (25.6mm) short diameters of the glenoid cavity were measured. The long and both superior and inferior short diameters were significantly longer in the males.
Acromion ; Cadaver ; Diagnosis ; Female ; Glenoid Cavity ; Humans ; Ligaments ; Male ; Scapula* ; Shoulder ; Spine

OBJECTIVETo investigate normal bony anatomy of the glenoid rim, to measure inner glenoid rim angle and outer glenoid rim angle, and the angles for successful anchor insertion for arthroscopic labral repairs.

METHODSTwelve unpaired isolated human glenoids (6 right, 6 left) without any evidence of trauma were for studying. The glenoid specimens were scanned using 320-slice CT (Aquilion ONE), then reconstruction glenoid to a three dimensional model using materialise's interactive medical image control system (Mimics) and to obtain cross-sectional images in 6 different planes, mark the right glenoid rim with clockwise tag, the left with counterclockwise tag. Inner glenoid rim angle marked as angle α and outer glenoid rim angle marked as angle β were measured from the cross-sectional images of the glenoids at 8 positions: 2-, 3-, 4-, 5-, 6-, 7-, 8- and 9-o'clock positions. Glenoid morphology was noted for each position. Using 12 mm as radius, measured the minimum insertion angle of anchor, marked as angle γ. Normal distribution of the data was confirmed with Kolmogorov-Smirnov test. Paired t-test was performed to detect differences in the angles between two locations. Two independent samples t-test was performed to detect differences in the angles between same location of left and right. Analysis of variance (ANOVA) was performed to detect differences in the angles between right and left, and different locations of the glenoid rim.

RESULTSThe smallest α was at the 4-o'clock position (right 50° ± 6°, left 52° ± 9°), significant difference were seen when compared with the 6-o'clock position (t = 10.466, P = 0.000) or the 5-o'clock position (t = 3.754, P = 0.003), no significant difference exist between 4-o'clock position and 3-o'clock posion (t = 0.926, P = 0.374). The smallest β was at the 3-o'clock position (right 50° ± 6°, left 53° ± 10°), significant difference were seen when compared with the 6-o'clock position (t = 9.862, P = 0.000) or the 5-o'clock position (t = 3.634, P = 0.003), no significant difference exist between 4-o'clock position and 3-o'clock posion (t = 0.697, P = 0.501). Asymmetric morphology of the glenoid was noted with an almost straight line extending medially from the rim at the 3-o'clock position, whereas a concave morthology was noted at the 9-o'clock position. Similary at the 4- and 5-o'clock position, the scapular bony surface did not curve toward the base as markedly as it did at the corresponding posterior 8- and 7-o'clock position. Angle γ from the 3-o'clock to the 9-o'clock were 25° ± 4°, 54° ± 6°, 83° ± 4°, 119° ± 2° at right side, 23° ± 4°, 57° ± 4°, 89° ± 7°, 119° ± 4° at left side. No significant difference of any angle at the same position was noted between left and right (α:t = 0.283-1.785, P > 0.05;β:t = 0.369-2.067, P > 0.05;γ:t = 0.145-0.492, P > 0.05).

CONCLUSIONSThe available bone mass for the anchor insertion is found to vary depending on the position of the glenoid rim. The smallest inner and outer glenoid rim angle are at the 4- and 3-o'clock position. The minimum insertion angles of anchor differ at different position. Both rim angle and glenoid morthology for each position must be considered when selecting the ideal anchor insertion angle for Bankart repair. Meanwhile, minimum insertion angle of anchor should also be considered before anchor insertion.

Otitis externa and otitis media spreading to the temporomandibular joint (TMJ) is rare, and infection to the TMJ may result as well from direct spreading from the adjacent structures or from hematogenous spreading. But, apparent pathomechanism is not identified clearly and more specific studies are required. We experienced 2 cases of otits media and otitis externa which involved dehiscence of the bony canal wall that communicates with TMJ and the glenoid cavity. We report this cases with literature.
Ear Canal* ; Ear, Middle* ; Glenoid Cavity ; Otitis Externa ; Otitis Media ; Temporomandibular Joint*

BACKGROUND: Reverse total shoulder arthroplasty has become a widely accepted surgical procedure in Japan since the time when the implants were approved for use in 2014. There is a doubt, however, as to whether the implants designed for Western people are suitable for Japanese people, particularly for females of relatively small stature. The purpose of this study was to investigate the glenoid dimension, with special focus on the length after glenoid reaming, in Japanese rotator cuff tear patients. METHODS: Fifty-six shoulders of 55 patients (35 males and 20 females; mean age, 63.8 years) were studied. Using the three-dimensional computed tomography images of the entire scapula before shoulder surgery, we measured the glenoid height and width, and calculated the correlation between these measurements and the patient's height. Further, we measured the anteroposterior length of the scapular neck at the subchondral bone and the length at 15 mm medial to the subchondral bone, to simulate both the glenoid width after reaming (width of the ‘virtual reamed surface’) and the space available for the end of the center post of a standard glenoid baseplate. RESULTS: The average glenoid height and width were 35.8 mm and 28.1 mm in males and 30.8 mm and 23.4 mm in females, respectively. There was a significant correlation between patient height and glenoid size (glenoid height, r = 0.69; width, r = 0.75; p < 0.01). The mean value of the width of the virtual reamed surface was 27.0 mm in males and 22.5 mm in females. The mean anteroposterior length at 15 mm medial to the subchondral bone was 12.4 mm in males and 9.5 mm in females; the length was shorter than 8 mm in 6 female shoulders. CONCLUSIONS: There was a significant correlation between patient height and glenoid size. Considering that the common diameter of the commercially available baseplates and their center posts is greater than 25 mm and 8 mm, respectively, these prosthetic parts would be too large, especially for the Japanese female glenoid. Given that the current results of Japanese shoulder dimensions are similar to those of Asian people, ‘Asian size implants’ should be developed.
Arthroplasty ; Asian Continental Ancestry Group* ; Female ; Glenoid Cavity ; Humans ; Japan ; Male ; Neck ; Rotator Cuff* ; Scapula* ; Shoulder ; Tears*

Synovial chondromatosis is a rare benign lesion originating from the synovial membrane. It presents as adhesive or non-adhesive intra-articular cartilaginous loose bodies. Although the causes of synovial chondromatosis have not been fully elucidated, inflammation, external injury, or excessive use of joints have been suggested as possible causes. Synovial chondromatosis has been reported to occur most frequently at large joints that bear weights, with a rare occurrence at the temporomandibular joint (TMJ). When synovial chondromatosis develops at TMJ, clinical symptoms, including pain, joint sounds, and mouth opening may common. Moreover, synovial chondromatosis rarely spreads to the mandibular condyle, glenoid cavity, or articular eminence of TMJ. The goal of this study was to discuss the methods of surgery and other possible considerations by reviewing cases of patients who underwent surgery for synovial chondromatosis that extended to the temporal bone.
Adhesives ; Arthralgia ; Chondromatosis, Synovial* ; Glenoid Cavity ; Humans ; Inflammation ; Joints ; Mandibular Condyle ; Mouth ; Synovial Membrane ; Temporal Bone* ; Temporomandibular Joint* ; Weights and Measures