title: An alternative endoscopic portal for suprascapular nerve approach: an anatomic study.
abstract: OBJECTIVE
  Arthroscopic approaches have been less preferred than open techniques for treating suprascapular nerve entrapment, possibly because current arthroscopic portals are based on distances to reference points, resulting in discrepancies from differing shoulder sizes. This study reports a portal placement based on proportions rather than absolute length.
  
  
  METHODS
  Open dissection (12 left shoulders) and arthroscopy (12 contralateral shoulders) of the suprascapular notch were performed. In left shoulders, the posterolateral prominence of the acromion, the T1 spinous process, and the suprascapular notch were marked (K-wires). Distances from the posterolateral prominence of the acromion to the suprascapular notch and to the T1 spinous process were measured, and the proportion of those distances (distance to the suprascapular notch/distance to the T1 spinous process) was calculated to indicate the portal's location. In right shoulders, arthroscopy anatomically assessed that proportion's reliability.
  
  
  RESULTS
  Median distances from the posterolateral prominence of the acromion to the T1 spinous process and to the suprascapular notch were 175.7 mm (average 180.4, SD 11.8 mm) and 72.3 mm (average 73.9, SD 4.9), respectively. The medians of the proportions of the defined distances were 40.9 % (range 40-42 %) and 41 % (range 39.3-42.1 %), respectively.
  
  
  CONCLUSIONS
  Locating the portal at the lateral, 41 % of the distance between the posterolateral prominence of the acromion and the T1 spinous process was accurate and reproducible for suprascapular notch visualization. Clinically, this portal seems to eliminate perioperative morbidity by reducing excessive soft-tissue dissection with a shorter arthroscopic route and avoiding the ligamentous damage.
authors: Division of Shoulder Surgery, The Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD, 21287, USA.|The Department of Orthopedics and Traumatology, Faculty of Medicine, Cukurova University, Cukurova University Rectorate, 01330, Balcali, Saricam, Adana, Turkey.
authors: Gazi
authors: G
authors: Huri
authors: The Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06532, Ankara, Ankara Province, Turkey.
authors: Akin
authors: A
authors: Üzümcügil
authors: The Department of Orthopedics and Traumatology, Faculty of Medicine, Cukurova University, Cukurova University Rectorate, 01330, Balcali, Saricam, Adana, Turkey.
authors: Omer S
authors: OS
authors: Biçer
authors: The Department of Anatomy, Faculty of Medicine, Mersin University, Yenisehir, 33343, Mersin, Mersin Province, Turkey.
authors: Hakan
authors: H
authors: Ozturk
authors: Division of Shoulder Surgery, The Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline Street, Baltimore, MD, 21287, USA.|Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, The Johns Hopkins University, 4940 Eastern Ave., #A665, Baltimore, MD, 21224-2780, USA.
authors: Edward G
authors: EG
authors: McFarland
authors: The Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, 06532, Ankara, Ankara Province, Turkey. mndoral@gmail.com.
authors: Mahmut N
authors: MN
authors: Doral
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D002102:Cadaver; D006801:Humans; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000517:prevention & control*; D010525:Peripheral Nerves / Q000601:surgery*; D015203:Reproducibility of Results; D012785:Shoulder Joint / Q000601:surgery*