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Risk of suprascapular nerve injury in open Trillat procedure: an anatomical study

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Abstract

Purpose

The open Trillat Procedure described to treat recurrent shoulder instability, has a renewed interest with the advent of arthroscopy. The suprascapular nerve (SSN) is theoretically at risk during the drilling of the scapula near the spinoglenoid notch. The purpose of this study was to assess the relationship between the screw securing the coracoid transfer and the SSN during open Trillat Procedure and define a safe zone for the SSN.

Methods

In this anatomical study, an open Trillat Procedure was performed on ten shoulders specimens. The coracoid was fixed by a screw after partial osteotomy and antero-posterior drilling of the scapular neck. The SSN was dissected with identification of the screw. We measured the distances SSN-screw (distance 1) and SSN-glenoid rim (distance 2). In axial plane, we measured the angles between the glenoid plane and the screw (α angle) and between the glenoid plane and the SSN (β angle).

Results

The mean distance SSN-screw was 8.8 mm +/-5.4 (0–15). Mean α angle was 11°+/-2.4 (8–15). Mean β angle was 22°+/-6.7 (12–30). No macroscopic lesion of the SSN was recorded but in 20% (2 cases), the screw was in contact with the nerve. In both cases, the β angle was measured at 12°.

Conclusion

During the open Trillat Procedure, the SSN can be injured due to its anatomical location. Placement of the screw should be within 10° of the glenoid plane to minimize the risk of SSN injury and could require the use of a specific guide or arthroscopic-assisted surgery.

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Data availability

Not applicable.

Abbreviations

BMI:

Body Mass Index

SSN:

Suprascapular Nerve

SD:

Standard Deviation

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Funding

This research did not receive any specific grand from funding agencies in the public, commercial, or not-for-profit sectors. Authors, their immediate families, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, FIFA Medical Center of Excellence, Lyon, 69004, France

    Lyliane Ly, John Swan, Riza B. Özbek, Elvire Servien & Sebastien Lustig

  2. Interuniversity Laboratory of Biology of Mobility, LIBM – EA 7424, Claude Bernard Lyon 1 University, Lyon, France

    Elvire Servien

  3. University Lyon, IFSTTAR, LBMC UMR_T9406, Claude Bernard Lyon 1, Lyon, 69622, France

    Sebastien Lustig

  4. Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, 24 avenue Paul Santy, Lyon, 69008, France

    Stanislas Gunst

Authors
  1. Lyliane Ly
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  2. John Swan
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  3. Riza B. Özbek
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  4. Elvire Servien
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  5. Sebastien Lustig
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Contributions

LL: data collection, data analysis, manuscript writing. JS: manuscript editing. RBO: data collection. ES: manuscript editing. SL: manuscript editing. SG: protocol development, manuscript editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Stanislas Gunst.

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Ethical approval

All procedures were performed in accordance with the ethical standards of the institutional and/or national research committee, the 1964 Helsinki declaration and its later amendments, or comparable ethical standards. This study was exempted from IRB review in accordance with the exemption criteria laid down by the institutional review board of our hospital (Hospices Civils de Lyon, Lyon, France). The Ethics committee did not ask for any consent. Cadavers were obtained from the Anatomy department of Lyon 1 University, which is a French institution that handles cadavers for research and education purposes. None of the authors had access to patient data identifications.

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The authors declare that they have no competing interests.

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Ly, L., Swan, J., Özbek, R.B. et al. Risk of suprascapular nerve injury in open Trillat procedure: an anatomical study. Surg Radiol Anat 46, 451–461 (2024). https://doi.org/10.1007/s00276-024-03337-6

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