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PubMed2005

Role of development in the evolution of the scapula of the giant sthenurine kangaroos (Macropodidae: Sthenurinae).

Extinct giant sthenurine kangaroos possessed scapulae morphologically distinct from those of all other extant and extinct adult macropodids, but qualitatively resembling those of newborn macropodids. The similarity between adult sthenurine and neonatal macropodid scapulae suggests that a developmental process, such as heterochrony, might have been behind the evolution of the unique sthenurine scapular morphology. By incorporating adult and ontogenetic data, this study examines the evolution and development of the sthenurine scapula. This study quantitatively upholds the previous qualitative morphological observations of macropodid scapulae and finds that ontogenetic and evolutionary morphological changes are correlated in macropodids. The similarity of scapula morphology in sthenurines and newborn macropodids, the correlation between ontogenetic and evolutionary morphological change, and information from other sources (i.e., sthenurine evolutionary history) suggests that pedomorphic shifts in morphology, most likely due to neotenic processes, occurred within the development of the scapula of giant sthenurines.

Animals↗
PubMed2006

Deviation of skin marker from bone target during movement of the scapula.

BACKGROUND: Recording movement of the scapula by non-invasive techniques is fraught with technical difficulty. One convenient method involves placing a single marker on the skin overlying the acromion. The purpose of this study was to compare translatory discrepancies between marker and underlying bone for seven markers affixed to the skin overlying different parts of the scapula. METHODS: The markers were small plastic spheres filled with machine oil, clearly visible on magnetic resonance imaging (MRI), placed over seven loci of the scapula, including the acromion, spine, medial border, lateral border, and inferior angle. Nine healthy men participated, assuming three positions in the MRI apparatus: (1) arm at the side of the trunk (starting position); (2) arm in full elevation over the head; and (3) hand placed behind the back at the thoracolumbar area. Visible markers and three loci of the scapula itself were digitized on each MRI scan, enabling calculation of changes in location of each marker relative to the scapula between the starting position and either of the other two positions. RESULTS: Among the seven loci examined, the marker placed atop the acromion deviated least from its target, 39 +/- 1 mm (mean +/- standard deviation) for full elevation and 15 +/- 1 mm for moving the hand behind the back. Markers along the medial border and at the inferior angle exhibited relatively large deviations, on the order of 8 mm for full elevation and 3 mm for moving the hand behind the back. CONCLUSIONS: For the two movements studied, involving full range of motion in the shoulder complex, translation of the scapula is most accurately recorded if the marker is placed over the acromion, but the systematic error is too large for such tracking to be deemed precise.

Acromioclavicular Joint↗
PubMed1997

A comparative study of removal torque of endosseous implants in the fibula, iliac crest and scapula of cadavers: preliminary report.

This study was undertaken to compare removal torque of endosseous implants in the fibula, iliac crest and scapula of cadavers. The fibulae, iliac crests and scapulae were harvested from the right side of 5 formalin-preserved cadavers. Endosseous implants (Brånemark System) were placed at 3 points of each bone. The removal torque of the implant was measured by a torque gauge manometer (Tohnichi 15 BTG-N). After measurement of the removal torque, the bone was cut at each implant site. The thicknesses of cortical and total bone were measured. The mean removal torques were 46.3 N cm in the fibulae, 15.2 N cm in the iliac crests and 21.4 N cm in the scapulae. There was a statistically significant difference in mean removal torque between the three bones. The total bone thicknesses were 11.7 mm in the fibulae, 9.9 mm in the iliac crests and 8.2 mm in the scapulae. The cortical bone thicknesses were 5.0 mm in the fibulae, 1.6 mm in the iliac crests and 1.8 mm in the scapulae. Significant correlation between the removal torque and the cortical bone thickness was found. However there was no significant correlation between the removal torque and the total bone thickness. In conclusion, the implants inserted in the fibulae showed the highest removal torques as compared to the ones inserted in the iliac crests and the scapulae. Moreover the removal torque was related to the thickness of the cortical bone in the implant sites.

Adult↗
PubMed2002

Constrained total scapula reconstruction after resection of a high-grade sarcoma.

Patients with high-grade sarcomas arising from the scapula or periscapular soft tissues traditionally have been treated with either a total scapulectomy or a wide, en bloc, extraarticular scapular resection, termed the Tikhoff-Linberg resection. The major challenge after such resections is to restore shoulder girdle stability while preserving a functional hand and elbow. The current authors describe three patients who had an extraarticular, total scapula resection (modified Tikhoff-Linberg) for a high-grade sarcoma. Each patient had reconstruction with a constrained (rotator cuff-substituting) total scapula prosthesis in an effort to optimally restore the normal muscle force couples of both glenohumeral and scapulothoracic mechanisms. At latest followup, the Musculoskeletal Tumor Society functional score was 24 to 27 of 30 (80%-90%). All patients had a stable, painless shoulder and functional hand and elbow. Forward flexion and abduction ranged from 25 degrees to 40 degrees. Glenohumeral rotation (internal rotation, T6; external rotation -10 degrees) below shoulder level, shoulder extension, and adduction were preserved. Protraction, retraction, elevation, and abduction of the scapula were restored and contributed to shoulder motion and upper extremity stabilization. There were no complications. Total scapula reconstruction with a constrained total scapula prosthesis is a safe and reliable method for reconstructing the shoulder girdle after resection of select high-grade sarcomas. The authors emphasize the clinical indications, prosthetic design, surgical technique, and early functional results.

Adolescent↗
PubMed2006

Effects of polyvinyl chloride overwrap film, high-oxygen modified atmosphere packaging, or ultra-low-oxygen modified atmosphere packaging on bone marrow discoloration in beef humerus, rib, thoracic vertebra, and scapula.

Meat retailers have reported bone marrow discoloration to be a problem, especially in modified atmosphere packages (MAP). Therefore, it is important to determine the prevalence and cause(s) of bone marrow discoloration in different beef bones and packaging systems. Thirty-six beef humeri, ribs, scapulas, and thoracic vertebrae from USDA Select and Choice carcasses were obtained from a commercial abattoir, cut into 2.54-cm-thick sections at 4 d postmortem, and packaged into 1 of 3 systems: 1) polyvinyl chloride film (PVC) overwrap; 2) high-oxygen (80% O2, 20% CO2) MAP; and 3) ultra-low-oxygen (70% N2, 30% CO2) MAP. Instrumental reflectance and visual color scores were taken on d 0, 2, and 4, and on d 0 to 4 of display, respectively. Bone marrow was extracted from humeri, ribs, and thoracic vertebrae for analysis but not from scapulas. Ribs, scapulas, and thoracic vertebrae packaged in PVC and high-oxygen MAP developed undesirable gray or black discoloration. In ultra-low-oxygen MAP, mean visual color scores were acceptable throughout the entire display period. Discoloration (darkening) was more extensive for ribs, scapulas, and thoracic vertebrae than for humeri, especially for bones packaged in PVC and high-oxygen MAP. Humeri had lower (P < 0.05) a* values (larger positive a* values indicate a redder color) than the other bones. The a* values for ribs, scapulas, and thoracic vertebrae decreased (P < 0.05) over time. Chroma showed that bone marrow discolored during display, but graying was dramatically less for all bones packaged in ultra-low-oxygen MAP and for humeri in PVC and high-oxygen MAP. Humeri marrow had lower (P < 0.05) 2-thiobarbituric acid reactive substances (TBARS) than did ribs and thoracic vertebrae marrow. Ultra-low-oxygen MAP resulted in the least amount of change in TBARS from d 0 to 4, whereas thoracic vertebrae marrow had greater (P < 0.05) TBARS values at d 4 of display than at d 0 in PVC and high-oxygen MAP. Humeri marrow had dramatically less total Fe and hemoglobin than did that of ribs and thoracic vertebrae for all packaging systems. Myoglobin was undetectable in humeri marrow. The much larger amounts of Fe and hemoglobin in ribs and thoracic vertebrae likely contribute to marrow discoloration. Bone marrow discoloration was distinct in ribs, scapulas, and thoracic vertebrae packaged in PVC or high-oxygen MAP. Bones packaged in ultra-low-oxygen MAP had minimal discoloration.

Animals↗
PubMed2002

[Trial manufacture of subsidiary tool and use of technique for shoulder joint of "Scapula Y"].

The technique of "Scapula Y " is effective for capturing forward/backward dislocation of the humeral head and variation in surgical spine fracture. It is also indispensable for describing images of ossification at the tendon plate of the lower lobe of the acrominon and impingement syndrome. However, owing to large individual variations in body shape and position and shape of the scapula, the conventional method does not lend itself to stable reproduction of position or provide adequate diagnostic information. We measured the central angle of entry from scapula m24 pairs of dried bone (Indian) into the spine of the scapula from horizontal and forehead planes to determine the range of variation together with the clinical data referred to in the next paragraph. We then manufactured a trial subsidiary tool to set the angle of the central entering beam base on the acrominon to the spine of the scapula using data on measured angle from 50 clinical radiographs. We identified improvement in radiography of the scapula by using the subsidiary tool designed and manufactured on the basis of the above measured data.

Anthropometry↗
PubMedDate not supplied

Interface of unloaded titanium implants in the iliac crest, fibula, and scapula: a histomorphometric and biomechanical study in the pig.

PURPOSE: Prefabrication of free vascularized fibular flaps is a 2-stage procedure for the reconstruction of maxillary and mandibular defects. The delay between prefabrication and flap transfer is 6 weeks and depends on biomechanical stability and osseointegration of the implants. The purpose of this animal study was to evaluate implant stability by measuring the removal torque values (RTVs) at 3, 6, and 12 weeks and to compare the results with interface strength of the bone-implant surface in the fibula, the scapula, and the iliac crest under unloaded conditions. MATERIALS AND METHODS: ITI implants (n = 108) with a sandblasted and acid-etched surface were placed in the fibula, the scapula, and the iliac crest of 6 Yorkshire pigs. Biomechanical, histologic, and histomorphometric results were collected at 3, 6, and 12 weeks, respectively. RESULTS: Bicortical anchored 8-mm implants in the fibula (63.7 to 101.8 Ncm) showed RTVs similar to those of monocortical anchored 12-mm implants in the scapula (62.3 to 99.7 Ncm). The RTVs of monocortical anchored 8-mm and 10-mm implants in the iliac crest (19.1 to 44.3 Ncm) and the scapula (27.2 to 55.3 Ncm) were significantly lower. The bone-to-implant contact in the fibula at 3, 6, and 12 weeks (35.2%, 44.4%, and 46.8%, respectively) was similar to that in the iliac crest (24.2%, 44.2%, and 52.5%, respectively), but significantly lower than in the scapula (63.7%, 73.8%, and 74.2%, respectively). DISCUSSION AND CONCLUSION: Bicortical anchorage determined implant stability in the fibula, whereas interfacial strength seemed to define stability in the scapula. The quality and type of bone determined the bone's response in terms of biomechanical press fit or biologic interface strength.

Animals↗
PubMed2006

[Operative treatment of severe forms of congenital elevation of the scapula in children].

The article presents results of operative treatment of 36 children with severe forms of congenital high scapula. An original and used by us method of operative treatment of children with a severe form of Sprengel deformity is described. Distinctive features of the method are: mobilization of the suprascapular vascular-nervous bundle, correction of scapula deformities followed by a recovery of congruency of the sliding surfaces of the scapula and chest, physiological fixation of the scapula in the new place, separating off the paravertebral muscles and their sewing on to the medial edge of the scapula that allows a recovery of the function of lost trapezoid and rhomboid muscles and in some cases a shortening osteotomy of the clavicle is performed preventing the descending of the scapula. An analysis of the external view of the shoulder made after the operation has shown that the result was good in 57.5% of children, satisfactory in 42.5%. The functional indices characterizing the increased amplitude of movements in the shoulder joint were good in 47.5%, and satisfactory in 52.5%. The cosmetic and functional results of the treatment allow the developed technique to be recommended for treatment of severe forms of the Sprengel disease in children.

Adolescent↗
PubMed1993

[The scapula flap--overview and personal experiences].

Since the first report in the literature by Dos Santos in 1980, the scapula flap has become one of the most commonly used fascio-cutaneous free flaps. This is due to its numerous advantages and its few inconvenients. Because of the constant anatomy, the minor donor site defect and its good aesthetic result, the scapula flap replaced other more traditional flaps such as the radial forearm or the latissimus dorsi flap. Being a flap of the "subscapular artery system", it offers the possibility to be harvested "en bloc" with the other flaps of this system for complex reconstruction procedures. In our opinion, the scapula flap is the treatment of choice to treat cutaneous defects of the lower extremity which could not be covered by local flaps. In head-neck reconstruction, the colour and texture of the skin offered by this flap is superior to other free flaps. A thick, well visible horizontal scar in the donor site is the only real inconvenience of the scapula flap. It seems that the parascapula-flap (Nassif et al. 1982) which offers the same properties as the scapula flap is on the way to replace the scapula flap in the future. After a six-year experience with this flap we will present a current concept review and our own experience based on 30 cases. Moreover, we would like to report on some technical refinements.

Adolescent↗
PubMed1984

Innervation of the levator scapulae, the serratus anterior, and the rhomboideus in crab-eating macaques and its morphological significance.

The origin, course and distribution of the nerves supplying the levator scapulae, the serratus anterior, and the rhomboideus were carefully examined in four body-halves of crab-eating macaques. The levator scapulae arises from all the cervical vertebrae and is continuous with the serratus anterior, which arises from the upper ten ribs. The rhomboideus originates not only from the dorsal midline but also from the occipital bone. 6 segmental nerves from C3 to C8 innervate the 3 muscles: C3, C4, C5, and C6 innervate the levator scapulae; C6, C7, and C8 the serratus anterior; and C3, C4, C5, and C6 the rhomboideus. Each segmental nerve of supply originates as one or 2 branches from the dorsal surface of the corresponding root of the cervico-brachial plexus and runs dorso-caudally to enter the muscles. After supplying them, 6 or 7 branches pierce the levator scapulae and serratus anterior to reach the deep surface of the rhomboideus which they innervate. The upper segmental nerve tends to be distributed to the upper part of the muscle it innervates, while the lower segmental nerve is distributed to the lower part. According to the relationships between nerves and muscles, these 3 muscles may be regarded as the most medial of the dorsal musculature which is connected to the pectoral girdle and limb, as they are in man. It may surmised that the occipital portion of the rhomboideus and the caudal portion of the levator scapulae in crab-eating macapues correspond to the cranial portions of the levator scapulae and serratus anterior, respectively, in man.

Animals↗
PubMed1999

Functional and historical determinants of shape in the scapula of Xenarthran mammals: evolution of a complex morphological structure.

The mammalian scapula is a complex morphological structure, composed of two ossification plates that fuse into a single structure. Most studies on morphological differentiation in the scapula have considered it to be a simple, spatially integrated structure, primarily influenced by the important locomotor function presented by this element. We used recently developed geometric morphometric techniques to test and quantify functional and phylogenetic influences on scapular shape variation in fossil and extant xenarthran mammals. The order Xenarthra is well represented in the fossil record and presents a stable phylogenetic hypothesis for its genealogical history. In addition, its species present a large variety of locomotor habits. Our results show that approximately half of the shape variation in the scapula is due to phylogenetic heritage. This is contrary to the view that the scapula is influenced only by functional demands. There are large-scale shape transformations that provide biomechanical adaptation for the several habits (arboreality, terrestriality, and digging), and small scale-shape transformations (mostly related to the coracoid process) that are not influenced by function. A nonlinear relationship between morphometric and phylogenetic distances indicates the presence of a complex mixture of evolutionary processes acting on shape differentiation of the scapula.

Animals↗
PubMed2007

The pillars of the scapula.

Total shoulder replacement has been shown to provide predictable pain relief and functional improvement in patients with glenohumeral arthritis. Loosening of the glenoid component remains the most frequent indication for revision surgery at long-term follow-up. The component most widely used is an all-polyethylene keeled or pegged design cemented to the glenoid cavity of the scapula. The glenoid is small and its cup-shaped morphology allows only a restricted site for limited fixation devices. This is particularly so in revision surgery where there are often large bony defects of the glenoid. In an anatomical study, we investigated the scapula in order to identify substantial bony pillars for better component fixation. Forty cadaveric shoulders (mean age 86, range 67-101) were dissected, the glenoids were denuded from cartilage, and the subchondral and cancellous bone was removed. Two bony pillars approaching the glenoid were consistently identified in all scapulae investigated. These pillars were outlined by three cortices and orientated to the circle formed by the rim of the inferior quadrants of the glenoid. One pillar is directed inferiorly near the margo lateralis and the other pillar is directed superiorly into the spine of the scapula. We defined these pillars in length and direction, and three-dimensionally located them in relation to the joint surface. This study demonstrated two bony pillars as important anatomical landmarks in the scapula. They were constant in presence, surgically accessible, and have not been described before. These results can be used as a guideline in the development of prosthetic designs to improve the fixation of glenoid components.

Acromion↗
PubMed1986

Muscular attachments along the medial border of the scapula.

The authors described in this report the mode of attachments of muscles along the medial border of the scapula, as seen in sixty adult Indians. The levator scapulae, rhomboideus major and minor muscles comprise of double folds at the scapular end. The posterior folds of the levator scapulae and the rhomboideus minor muscles were attached to the dorsal surface of the medial border of the bone opposite the supraspinous fossa and the root of the spine respectively, while their anterior flaps gained attachment on the costal surface of the border at the level of the root of the scapular spine. The latter muscle reached much lower than the former. The rhomboideus major muscle was attached on the medial border of the scapula opposite the infraspinous fossa and could be traced to the dorsal surface of the bone just above the inferior angle. All the three muscles overlapped the costal surface of the serratus anterior fascia for about three centimeters. The fasciae of the muscles merged with each other along a straight line joining the free margins of their costal flaps. The serratus anterior muscle surrounds the superior and inferior angles of the scapula and is thus attached to both the surfaces of the bone at these sites.

Adult↗
PubMed2002

Ontogenetic data and the evolutionary origin of the mammalian scapula.

One of the most useful diagnostic therian features is the division of the lateral surface of the scapula into two fossae separated by a scapular spine. A new model to describe this evolutionary innovation based on ontogenetic data is provided, consistent with information provided by recent fossil discoveries. The development of the scapula in three didelphid and one dasyurid marsupials using histological sections was studied. Only the ventral, acromial portion of the scapular spine, which originates from the anterior margin of the scapular blade, is preformed in cartilage. The major dorsal portion is formed at a later stage by appositional bone, which expands from the perichondral ossification of the scapula into an intermuscular aponeurosis between the supra-and infraspinatus muscles. This intermuscular aponeurosis inserts more or less in the middle of the lateral surface of the developing scapula. Thus, the floor of the supraspinous fossa is already present at the beginning of scapular development, simultaneous with the infraspinous fossa. The portion of the scapular spine that is situated dorsal to the acromial process is hypothesized to be a neomorphic structure of therians. The dorsal portion of the scapular spine evolved as additional attachment for powerful supraspinatus and infraspinatus muscles meeting near the middle of the lateral scapula.

Animals↗
PubMed1997

The scapula as a window to the diagnosis of skeletal dysplasias.

Evaluation of the scapula can be useful in the diagnosis of skeletal dysplasias and helpful for the classification and delineation of new entities. A review of 2100 computerized cases of skeletal dysplasias in the International Skeletal Dysplasia Registry was performed. We found that the Luton type of platyspondylic lethal skeletal dysplasia differed radiographically from the San Diego type and Torrance type by the presence of two spikes at the inferior angle of the scapula. Hypoplasia of the body of the scapula, which is characteristic for campomelic dysplasia but not for kyphomelic dysplasia, is also present in Antley-Bixler syndrome. Radiographic and clinical similarities between campomelic dysplasia and Antley-Bixler syndrome suggest that they might be related disorders and that the latter condition should be included in the bent-bone dysplasia group. Similarity between the metaphyseal regions of the scapula and the metaphyses of the long tubular bones in the different types of short-rib polydactyly syndrome illustrates the importance of evaluation of the scapula in this group as well as in other well-defined or unknown osteochondrodysplasias.

Bone Diseases, Developmental↗
PubMed1992

Compartment syndrome of the scapula. Definition on clinical, neurophysiological and magnetic resonance data.

Compartment syndromes of the scapula and pelvic girdle have received scant attention in the literature. In 1938, Comolli first described a clinical sign which he considered specific to fracture of the scapula. We report data on two patients, one presenting with prolonged pressure on the posterior surface of the scapula and the other with symptoms associated with scapular fracture. In one of these patients we were able to measure pressures around the scapula, perform neurophysiological assessment of nerve function and produce magnetic resonance images of the area. In the other case, surgical exploration revealed an established ischaemic contracture of the infraspinatus muscle within its compartment. These findings suggest that the muscles around the scapula are vulnerable to the development of compartment syndrome.

Action Potentials↗
PubMed2000

Inferior angle of the scapula as a vascularized bone graft: an anatomic study.

In reconstructing patients with massive midface losses, the authors required a vascularized bone graft that could be used to reconstruct the palate and orbital floor, provide vertical maxillary support, and provide soft tissue. The inferior angle of the scapula appears to be a promising source of vascularized bone stock, and until now, there has been no clear description of its vascular anatomy. The purpose of this study was to define the vascular anatomy of the inferior angle of the scapula. Thirteen fresh cadavers were studied. The subscapular artery was injected with Microfil (Flow Tec, Carver, MA) at its origin. Two branches of the subscapular artery were found to converge on the angle of the scapula: the descending osseous branch of the circumflex scapular, and the transverse branch of the thoracodorsal. The descending osseous branch of the circumflex scapular artery supplied the inferior angle of the scapula in 100 percent of cases. The transverse branch of the thoracodorsal artery supplied it in 76 percent of cases. The descending osseous branch of the circumflex scapular artery is the principal artery supplying the inferior angle of the scapula.

Adult↗
PubMed1981

Relocation of congenitally elevated scapula.

In the treatment of Sprengel's deformity, extraperiosteal greenstick fracture of the clavicle in conjunction with surgical release of all attachments between the scapula and the spine provides an easy, safe method of relocating the scapula to its normal level. The improved position is maintained by temporary fixation of the inferior border of the scapula to the eighth rib with slowly resorbable sutures. Section of the coracoclavicular ligaments, excision of the superior pole of the scapula, and suture fixation of the medial angle of the scapula to the spinous process of the fourth vertebra enables the procedure to be performed on patients until the age of puberty. This surgical technique has been performed in 28 consecutive patients with Sprengel's deformity, aged 4 to 19 years, without any neurovascular complications. A normal scapular position was achieved in 67% of cases, 1 to 2 cm elevation in 29%, and 5 cm in 4%.

Adolescent↗