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Relationship of Intraoperative Anatomical Landmarks, the Scapular Plane and the Perpendicular Plane with Glenoid for Central Guide Insertion during Shoulder Arthroplasty
Clinics in Shoulder and Elbow 2018;21:113-119
Published online September 1, 2018
© 2018 Korean Shoulder and Elbow Society.

Jung-Han Kim, Young-Kyoung Min

Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
Correspondence to: Young-Kyoung Min
Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea
Tel: +82-51-890-6129, Fax: +82-51-892-6619, E-mail: dazuri@hanmail.net, ORCID: https://orcid.org/0000-0002-8076-7265
Received May 13, 2018; Revised June 12, 2018; Accepted June 20, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: This study was undertaken to evaluate the positional relationship between planes of the glenoid component (the scapular plane and the perpendicular plane to the glenoid) and its surrounding structures.
Methods: Computed tomography (CT) images of both shoulders of 100 patients were evaluated using the 3-dimensional CT reconstruction program (Aquarius®; TeraRecon). We determined the most lateral scapular bony structure of the scapular plane and measured the shortest distance between the anterolateral corner of the acromion and the scapular plane. The distance between the scapular plane and the midpoint of the line connecting the posterolateral corner of acromion and the anterior tip of the coracoid process (fulcrum axis) was also evaluated. The perpendicular plane was then adjusted to the glenoid and the same values were re-assessed.
Results: The acromion was the most lateral scapular structure of scapular plane and perpendicular plane to the glenoid. The average distance from the anterolateral corner of the acromion to the scapular plane was 10.44 짹 5.11 mm, and to the plane perpendicular to the glenoid was 9.55 짹 5.13 mm. The midpoint of fulcrum axis was positioned towards the acromion and was measured at 3.90 짹 3.21 mm from the scapular plane and at 3.84 짹 3.17 mm from the perpendicular plane to the glenoid.
Conclusions: Our data indicates that the relationship between the perpendicular plane to the glenoid plane and its surrounding structures is reliable and can be used as guidelines during glenoid component insertion (level of evidence: Level IV, case series, treatment study).
Keywords : Glenoid; Scapular plane; Glenoid plane; Total shoulder arthroplasty; Fulcrum axis