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KMID : 0311120220630070657
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Yonsei Medical Journal
2022 Volume.63 No. 7 p.657 ~ p.664
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Does the Suprascapular Nerve Move within the Suprascapular Notch? Biomechanical Perspective Using the Finite Element Method
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Yoo Yon-Sik
Jang Seong-Wook
Kim Yoon-Sang
Choi Jung-Ah
Oh Jung-Hyun
Jeong Jeung-Yeol
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Abstract
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Purpose: We aimed to analyze changes in suprascapular nerve (SSN) position within the suprascapular notch during in vivo shoul der abduction.
Materials and Methods: Three-dimensional models of the shoulder complex were constructed based on magnetic resonance im aging of the brachial plexus (BP-MR) in a patient diagnosed with SSN dysfunction but normal scapular movement. Using BP-MR inneutral position and computed tomography data on shoulder abduction, shoulder abduction was simulated as the transition be tween two positions of the shoulder complex with overlapping of a neutral and abducted scapula. SSN movement during abduc tion was evaluated using the finite element method. Contact stress on the SSN was measured in the presence and absence of thetransverse scapular ligament (TSL).
Results: In the neutral position, the SSN ran almost parallel to the front of the TSL until entering the suprascapular notch andslightly contacted the anterior-inferior border of the TSL. As shoulder abduction progressed, contact stress decreased due to grad ual loss of contact with the TSL. In the TSL-free scapula, there was no contact stress on the SSN in the neutral position. Towards theend of shoulder abduction, contact stress increased again as the SSN began to contact the base of the suprascapular notch in bothTSL conditions.
Conclusion: We identified changes in the position of the SSN path within the suprascapular notch during shoulder abduction.
The SSN starts in contact with the TSL and moves toward the base of the suprascapular notch with secondary contact. These find ings may provide rationale for TSL release in SSN entrapment.
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KEYWORD
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Suprascapular nerve entrapment, transverse scapular ligament decompression, scapular movement, finite element analysis
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