Anatomical Study Of Supraspinatus Tendon Adnclinical Application

ObjectiveTo provide the sectional imaging anatomy basis for the imaging diagnosis andsurgical treatment of supraspinatus and to establish the simulation of the surgical approachfor the best surgical repairing of Supraspinatus tendon through Making sectional anatomywith the shoulder specimens CT, MR in contrast, and combining the CT, MR of volunteersshoulder, researching supraspinatus muscle and its adjacent structures.Materials and MethodsTo collect8(male4, female4) shoulder specimens of the chinese adults. Thetransversal and coronary sectional specimens of8mm was obtained with an electricsectional beltsaw according to equal distance. To collect10healthy volunteers (male6,female4).The transversal and Coronal MR images were obtained by Netherlands PhilipsHDe1.5T systemic MR scanners and AW4.4type image post-processing workstation. Thetransversal and Coronal CT images of two healthy male volunteers were obtained by PhilipBrilliance64rows spiral CT through thin layer scanning. One healthy male volunteer wasinspected by the X-ray palne film.One shoulder specimens was used in supraspinatussimulating surgery after obtaining CT and MR images. To clarify complex anatomy of thesupraspinatus and its surrounding ligaments through contrasting continuous sectionalspecimens with CT and MRI images and combining shoulders specimens’s operationsimulation results.Results1. The transversal tomography via muscle belly of supraspinatus is the ideal level,ofobserving muscle belly,the transversal tomography via the middle of the humeral head isvery clear observing subscapularis and infraspinatus muscle, the coronal tomography via greater tuberosity is the ideal level,of observing supraspinatus tendon, either transversaltomography or coronal tomography can not show the complete picture ofsupraspinatus.Only oblique coronal tomography can clearly display the complete picture ofthe supraspinatus in cadavers and volunteers MR examination, the transversal tomographyvia the middle of the humeral head is very clear observing subscapularis and infraspinatusmuscle in MR images.It is unclear to display supraspinatus, subscapularis andinfraspinatus muscle,but it is significant for diagnosis of glenoid lip or shoulder boneinjury and acromioclavicular joint dislocation in cadavers and volunteers CT examination.2. Supraspinatus and its surrounding structure:supraspinatus muscle is starting in thesupraspinatus fossa, extending to anterolateral along the scapular, becoming tendinousorganization above the humeral head, continuing the outside by coracoacromial archbelow,enveloping the humeral head at the top glenohumeral joint, limiting to the upper ofthe greater tuberosity. the upper structure of supraspinatus is subacromial-deltoid bursa,thefollowing structure of supraspinatus is the capsule glenohumeral joint, the anteriorstructure of supraspinatus is coracobrachialis ligament,the back structure of supraspinatusis upper fiber of infraspinatus muscle.The distance from the supraspinatus tendon to theacromion and coracoacromial ligamentgradually is shorter and shorter,the distance is theminimum when abduction is90°.3.It is found that the trapezius walks more straight and level at1.5cm above thescapular position in anatomical process, traveling with supraspinatus. The surgical incisionat1.5cm above the scapular position is appropriate in deal In dealing with tear of thesupraspinatus muscle belly,because the surgical approach can clearly show thesupraspinatus after blunting dissection trapezius,and the surgery is easy and lessinvasive.When we are repairing the supraspinatus tendon tear, shoulder endoscopicrepairing is rational choice,duing to the complexity of the local structure. It has smallertrauma, quick recovery and good effect.Conclusion:.1. Either transversal tomography or coronal tomography can not show the completepicture of supraspinatus.Oblique coronal tomography can clearly display the completepicture of the supraspinatus in cadavers and volunteers MR examination. The transversaltomography via the middle of the humeral head is very clear observing.It is significant fordiagnosis of glenoid lip or shoulder bone injury and acromioclavicular joint dislocation incadavers and volunteers CT examination.2. Supraspinatus extends to anterolateral along the scapular, becoming tendinous organization above the humeral head, limiting to the upper of the greater tuberosity.It isprone to entrapment and impact between supraspinatus tendon and coracoacromialligament In the shoulder joint outreach.3.Transverse incision above the scapular spine is effective surgical approach inhandling the supraspinatus belly injury.When we are repairing the supraspinatus tendontear,shoulder endoscopic treatment is rational choice.