Anaesthesia considerations: Active Prosthetic Valve Endocarditis with cardiogenic shock

Author(s):Dr Rajvee K Gala, Dr Manojkumar Chauhan, Dr Rajkumar Vishwakarma, Dr Mayur Kumar, Dr Kunal Khera, Dr Saylee Dukhande

Received: 2025-02-13 Accepted: 2025-01-11 Published: 2025-02-23

Abstract

Introduction: The scapula, or shoulder blade, is a triangular bone that connects the upper limb to the trunk, articulating with the humerus at the glenoid cavity. It features three borders (superior, medial, and lateral), three angles (superior, inferior, and lateral), and significant anatomical landmarks such as the scapular spine, acromion, and coracoid processes. Understanding the scapula's morphology is vital for surgical procedures like the latarjet procedure and shoulder arthroscopy, as well as diagnosing conditions like impingement syndrome and nerve compression. The scapula's role in shoulder joint replacement highlights the importance of its anatomical features in prosthesis design.
Aim of the study: This study aimed to examine the morphometry of dry, fully ossified left human scapulae and identify variations between male and female scapulae.
Methods: This cross-sectional study, conducted at Dhaka Medical College from July 2022 to June 2023, analyzed 140 dry, fully ossified left human scapulae of unknown sex. Sex determination was performed using Dabbs's multivariate linear discriminant function method. Scapulae were classified into male and female groups based on measurements of various morphometric and morphological variables, including length, width, scapular angles, and glenoid cavity features. The study excluded damaged or degenerative scapulae. Data analysis was done using SPSS, with unpaired t-tests to compare sexes. Ethical clearance was obtained from the Research and Ethical Review Committees of Dhaka Medical College.
Result: To assess morphometric parameters and anatomical variations, the study examined 140 ossified left human scapulae (66 male, 74 female). Males had significantly larger measurements than females for scapular length, width, spine length, and other dimensions (p<0.05). In male, the mean ± SD of superior angle was 89.22 ± 4.94 mm and it ranged from 78.16mm to 98.16 mm. In female, the mean ± SD of superior angle was 85.49 ± 9.52 mm and it ranged from 45.00 mm to 96.66 mm. The mean superior angle was found to be higher in male than female and these differences were statistically significant (p<0.01). In male, the mean ± SD of inferior angle was 51.57 ± 6.13 mm and it ranged from 41.66 mm to 68.66 mm. In female, the mean ± SD of inferior angle was 48.75 ± 5.80 mm andit ranged from 36.66 mm to 75.12 mm. The mean inferior angle was found to be higher in male than female and these differences were statistically significant (p<0.01). As p<0.05, null   hypothesis (no difference in measurement of superior angle and inferior angle of scapula between male and female) was rejected and alternate hypothesis (there are differences in measurement of superior angle and inferior angle between male and female) was accepted. So, result was significant.
Conclusion: This study concludes that significant sexual dimorphism exists in the scapular morphology of adult Bangladeshi individuals. Males generally have larger scapular dimensions than females, and there are notable sex-based differences in anatomical variations, such as suprascapular notch types and acromion angles. 

Keywords: Scapula Morphometry, Sexual Dimorphism, Anatomical Variations, Human Scapula Anatomy

DOI: 10.5281/zenodo.14912183

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