The Incidence of Ossified Superior Transverse Scapular Ligament during Nerve Transfer through Posterior Shoulder Approach



1 Department of Plastic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Iran university of Medical Sciences, & Fellow of plastic and reconstructive surgery, Department of plastic surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Hand Surgery, Tehran University of Medical Science, Tehran, Iran

4 Department of Orthopedics, Imam Hospital Complex, Joint Reconstruction Research Center, Tehran, Iran


Background: The purpose of this study was to assess the incidence and importance of bony bridge that covers the
supra scapular notch during posterior approach to transfer accessory nerve to suprascapular nerve.
Methods: Between 2010 and 2015, the frequency and importance of suprascapular bony bridge instead of transverse
ligament was assessed among patients with brachial plexus injury candidate to shoulder function restoration by
accessory to suprascapular nerve transfer through posterior approach.
Results: Forty three patients, 41 male and 2 female, (mean age: 32.5 years, range 14 to 36) were included in this
study. Five male patients (11.6%) had a complete bony rim on the superior scapular notch. Suprascapular nerve
release needed osteotomy of the bony bridge and related equipment.
Conclusion: Although all previous cadaveric studies among different ethnic groups had reported the prevalence
between 0.3 to 30% of suprascapular canal, this in vivo study showed the incidence of 11.6%. Preoperative alertness
about this variation could make the exploration and release of the suprascapular nerve easier and reduce the risk of
nerve injury or failing to anatomize it.


Main Subjects