Repair of glenoid bone defects by scapular spinal autograft: Evaluating by three-dimensional reconstruction of CT images

  Background   The defect of shoulder glenoid caused by bony Bankart lesion is often repaired by coracoid process or iliac bone graft. However, both methods have certain complications.

  Objective   To explore the feasibility of the scapular spine as a bone graft material for repairing bony Bankart lesion by measuring the data of the scapular spine with three-dimensional reconstruction of CT images.

  Methods   Adult patients who underwent chest CT in the Fourth Medical Center of Chinese PLA General Hospital from January 2019 to January 2020 were randomly selected, including 23 males and 37 females, aged (41.48±12.97) years, for CT three-dimensional reconstruction of bilateral scapula. The area from 4 cm to 8 cm of the medial scapular spine was considered as the bone extraction area. The width of the glenoid defect was defined as 25% of the transverse diameter of the glenoid. The length, width, and height of the coracoid process and the scapular spine at medial 4 cm and 8 cm, respectively, and the longitudinal diameter and 25% of transverse diameter of the glenoid were measured.

  Results   Twenty-five percent of the transverse diameter of the glenoid was (6.44±0.82) mm. The length of bone from scapular spine was greater than the longitudinal diameter of shoulder glenoid (40.04±0.45 mm vs 34.12±3.79 mm, P＜0.001). There was no significant difference between the length of bone from scapular spine and the length of coracoid process (40.04±0.45 mm vs 39.20±4.13 mm, P＞0.05). The width of medial side of bone from scapular spine was greater than 25% of the transverse diameter of the glenoid (9.76±1.94 mm vs 6.44±0.82 mm, P＜0.001), and the width of lateral side of bone from scapular spine was greater than 25% of the transverse diameter of the glenoid (12.69±2.84 mm vs 6.44±0.82 mm, P＜0.001). The height of medial side of bone from scapular spine was greater than that of coracoid process (17.67±3.18 mm vs 9.40±1.54 mm, P＜0.001), and the height of lateral side of bone from scapular spine was greater than that of coracoid process (25.39±8.86 mm vs 9.40±1.54 mm, P＜0.001).

  Conclusion   Bone removal from the scapular spine can meet the requirements of bone grafting for severe bony Bankart lesion.