title: Classification and Morphological Parameters of the Scapular Spine: Implications for Surgery.
abstract: Incidence of scapular spine (SS) fractures as a result of complications of reverse total shoulder arthroplasty is relatively high leading to inferior clinical outcomes and an increased risk of revision and dislocation. Fractures of SS because of trauma, including the acromion, constitute 6% to 23% of scapula fractures. The purpose of this study was to classify the SS and present specific geometrical parameters according to osteologic features. A total of 319 intact dry scapulae were collected and classified based on morphological characteristics and shape of the SS. Nine bony landmarks were also chosen and described for their relevance to regions of interest for scapular fixation. Five specific types of SS were noted and the most prevalent groups were Type 1 (Fusiform shape) (47.17%) and Type 5 (Horizontal S-shape) (19.18%). Overall, Types 3, 4, and 1 showed thicker landmark values compared to Type 5, with Type 2 having smaller values. Our classification into 5 distinct types allowed appreciation of the anatomical variance of SSs. The contours of Types 5 and 1 presented a more complex morphology and may lead to a worse surgical approach due to a fracture. As Types 2 and 5 were much thinner than the other types, these may be more susceptible to fractures.
authors.affiliation: From the First Clinical College, Jinan University and Department of Orthopedics, The First Affiliated Hospital, Jinan University, Guangzhou, China (HJW, DBH, SWH, NL, JY, ZGZ); Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic, Rochester, MN, USA (HG); Department of Orthopedics, School of Traditional Chinese Medicine, Southern Medical University, Guangzhou (CC, YKL); Department of Orthopedics, Shenzhen Pingle Orthopedic Hospital, Shenzhen (YPG); and Department of Orthopedics, Guangzhou Orthopedic Hospital, Guangzhou, China (RGS).
authors.forename: Hua-Jun
authors.initials: HJ
authors.lastname: Wang
authors.forename: Hugo
authors.initials: H
authors.lastname: Giambini
authors.forename: Da-Biao
authors.initials: DB
authors.lastname: Hou
authors.forename: Song-Wei
authors.initials: SW
authors.lastname: Huan
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Yan-Ping
authors.initials: YP
authors.lastname: Gao
authors.forename: Ru-Guo
authors.initials: RG
authors.lastname: Shang
authors.forename: Yi-Kai
authors.initials: YK
authors.lastname: Li
authors.forename: Zhen-Gang
authors.initials: ZG
authors.lastname: Zha
mesh_terms: D044466:Asian People; D002681:China; D006801:Humans; D012016:Reference Values; D012540:Scapula / Q000033:anatomy & histology* / Q000601:surgery