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Subscapular Fossa

fossa subscapularis

The subscapular fossa is the broad concave anterior (costal) surface of the scapula, providing the origin of the subscapularis muscle over its medial three-quarters. The surface is marked by several oblique ridges providing attachment for tendinous septa within the subscapularis. The lateral one-quarter of the anterior scapula (lateral border) is the thickest part of the scapula, providing structural strength.

Region: Shoulder

Clinical Relevance

Clinical Notes

The subscapular fossa is accessed in the posterior approach for scapular fracture fixation, where extensive subscapularis takedown exposes the anterior scapula. In thoracoscopic surgery, the subscapular fossa relationship to the posterior chest wall is important. Subscapularis muscle tears from the lesser tubercle may be associated with fractures of the subscapular fossa lateral column in high-energy shoulder trauma. The subscapular fossa is the working space in posterior endoscopic shoulder procedures.

Pathology

Common Injuries & Conditions

Subscapular Fossa Fracture in High-Energy Shoulder Trauma

High-energy shoulder dislocation with glenoid rim fracture may extend the fracture line medially into the subscapular fossa along the scapular lateral column; CT classifies the fracture pattern and operative planning uses a posterior Judet approach for fixation of complex scapular body fractures.