Acromial Morphology and Subacromial Architecture in a South African Population

Abstract

SUMMARY: The acromion is classically described as one of the three scapular processes. Its antero-inferior aspect has been identified as the prime region of rotator cuff pathology. The purpose of this study was to determine the morphologic state of the acromion and the relative subacromial architecture within a South African population. The sample series comprised the morphological observation of one hundred and eighty-two scapulae specimens (n= 182). The classification scheme as stated by Bigliani et al. (1986) was employed. The morphometric architecture of the subacromial space was also investigated (n= 120). (a) Acromial Type: (i) Type I (flat inferior surface) 34.6%; (ii) Type II (curved inferior surface) 51.1%; (iii) Type III (hooked inferior surface) 14%. (b) Shape of the subacromial space: (i) rhomboid 60.8% (ii) triangular 10%, (iii) trapezoid 29.2%. Since this study investigated the acromial morphology and its association with the relevant demographic factors specific to the South African population, it may prove beneficial to the South African population as a whole. In addition, statistically significant differences were obtained for the correlation of several morphometric and morphological parameters of the subacromial architecture with age, sex, acromial type and shape of subacromial space. A unique trapezoidal subacromial space was also observed. As the variable acromial types and subacromial morphology have been reported to lead to the narrowed subacromial space and subsequent subacromial syndromes, the association between the respective morphometric and morphological parameters may provide predictive values to assist in the diagnosis and assessment of the cause of rotator cuff disease.

Morphometry of the Acromion Process in Dry Human Scapulae and Its Clinical Implications: A Cross-sectional Study

“…These values are consistent with other studies done in the Indian population [8,17,20]. A comparative description of morphometric parameters reported by various authors is given in 7,8,14,17,20,[28][29][30]. There is a higher chance of impingement when the thickness of the acromion is more than 8 mm [31].…”

“…This was followed by type I flat (31%) and type III hooked (21%). The morphology of the acromion process reported by various authors was compared in [7][8][9][11][12][13][14][15][16][17][18][19][20][21][22]. Type II was reported as the most common type of acromion process in most of the previous studies [4,[7][8][9][11][12][13][14][15][16], while a few studies described type I as the most common [21,23] [4,7,8,14,17,20,[28][29][30].…”

“…The mean acromiocoracoid distance, acromioglenoid distance, and height of the coracoacromial arch (mm) in the present study were 39.87±7.63 mm, 27.34±3.58 mm, and 21.52±1.98 mm, respectively. These parameters were compared with previous studies 7,8,14,17,19,20,22,[28][29][30]. The acromiocoracoid distance signifies the length of the coracoacromial ligament.…”

“…A decrease in the subacromial space increases the risk of impingement syndrome [4]. [4,7,8,14,17,19,20,22,[28][29][30].…”

“…Additionally, the dimensions and shape of bones vary within and between populations. The morphology and morphometry of the acromion process have been described by various authors in different populations [11][12][13][14][15][16]. Considering the variability and clinical relevance, the present study aimed to document the morphometry of the acromion process in the South Indian population.…”