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[Transplantation of the scapular bone vascularized by the thoracodorsal vessels. A new method of scapula transplantation].

Transplantation of the scapular bone vascularized by the thoracodorsal vessels offers some major advantages. This new myo-osseous grafting unit has the longest pedicle of all pedicled bone flaps used until now. It is particularly in difficult cases involving major parts of the maxillofacial region--as after neck dissection and irradiation--or distant regions such as the maxilla that its long pedicle and its anatomical configuration render the scapula an ideal graft.

Adolescent↗

PubMed1990

[Dynamic winged scapula].

Author describes the paralysis of the serratus muscle in consequence of the paralysis of the long thoracic nerve. The form of appearance is the winged of "flying" scapula. Beside the presentation of the literary and anatomical data the own cases are described. Only conservative therapy was made, an operation was in no case necessary.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1991

Osteoid osteoma of the scapula. A case report and review of the literature.

The scapula is a rare location for osteoid osteoma, which in most cases does not involve the flat bones. The en bloc excision in this uncommon location can be problematic since the surgical exposure is difficult, and shoulder joint function can be affected if the lesion is subchondral. In an 18-year-old man, an osteoid osteoma was located in the subchondral area of the glenoid. A guided needle biopsy of the nidus resulted in complete healing. This mode of treatment, with proper follow-up examination, is acceptable for a benign lesion situated in a problematic location.

Adolescent↗

PubMed1990

[Treatment of trapezius paralysis by transfer of the levator scapulae].

The authors present a technique of palliative treatment of trapezius paralysis after injury to the spinal accessory nerve. The transfer of the levator scapulae associated, or not, with the rhomboid minor allows regression of functional signs and a return to normal function of the shoulder. Five cases are exposed, with results ranging from 3 months to 15 years.

Accessory Nerve Injuries↗

PubMed1990

[Incisura scapulae syndrome].

The suprascapular nerve may rarely be entrapped in the suprascapular notch. This causes weakness of the supra- and infraspinatus muscles and pain in the glenohumeral and acromioclavicular joints, which are innervated by this nerve. The entrapment syndrome may result from direct or indirect trauma, fracture of the neck of the scapula, kinking or traction on a sling affecting the nerve, from the shape of the notch, compression by a ganglion, or its cause may be idiopathic. Diagnosis of the syndrome is based upon deep unceasing pain reported at the postero-lateral shoulder, atrophy of the supra- and infraspinatus muscles, and impaired shoulder external rotation and a lidocaine test. The final proof is taken from polyphasic EMG potentials which are decreased in amplitude and increased in distal latency. Initially the entrapment neuropathy may be treated by immobilization, analgesics, and physiotherapy. A tear of the rotator cuff as well as a frozen shoulder have to be excluded by arthrography. In persistent cases of pain and pathologic EMG findings surgical decompression of the nerve should be done. The trapezius muscle is approached by a postero-superior incision. Via the suprascapular fossa the notch may be reached. Then the nerve is decompressed by removing the transverse scapular ligament. Reports of the cases operated so far are promising, though their number is small.

Humans↗

PubMed1990

Radiation induced fracture of the scapula.

A case of radiation induced osteonecrosis resulting in a fracture of the scapula in a 76-yr-old female patient with a history of breast carcinoma is presented. Diagnostic imaging, laboratory recommendations and clinical findings are discussed along with an algorithm for the safe management of patients with a history of cancer and musculoskeletal complaints. This case demonstrates the necessity of a thorough investigation of musculoskeletal complaints in patients with previous bone-seeking carcinomas.

Aged↗

PubMed1990

[A case of long thoracic nerve palsy, with winged scapula, as a result of prolonged exertion on practicing archery].

Reports of isolated long thoracic nerve palsy are rare in Japan. We reported a case of isolated long thoracic nerve palsy, resulted from recurrent injury to the nerve. Muscle CT and electrodiagnostic study were useful for confirming diagnosis of this cases. This patient was a student aged 20 years, with nothing of importance in his family or past history. After he started practicing archery, winging of left scapula was gradually developed. Physical examination revealed weakness and atrophy of left serratus anterior muscle. There was no wasting and weakness of other should girdle muscles. Hematochemical tests were normal, except slight hyperthyroidism. Radiography and myelography of the cervical spine were normal. Muscle CT of upper thoracic level demonstrated atrophy of left serratus anterior muscle, and no abnormality were found in other muscles. Electromyogram of the left serratus anterior revealed discrete activity of reduced amplitude, and fibrillation potentials and positive sharp waves. Conduction time for left long thoracic nerve was prolonged, and amplitude of the evoked response was small and there were temporal dispersion. Muscle CT and electrodiagnostic studies were suggestive of neuroapraxia of left long thoracic nerve. Over stretching or compression during exercises may be responsible for the damage to the long thoracic nerve.

Adult↗

PubMed1989

[Desmoid fibroma of the scapula. Recurrence with pulmonary metastasis].

A 22 year old woman presented with a desmoid tumour located in the subspinal fossa of the right scapula. A recurrence was observed 3 years after local excision. This recurrence was accompanied by pulmonary metastases. A new excision of the tumour and a pulmonary biopsy confirmed the similarity of that tumour with the original one. Six years after the initial operation the pulmonary lesions extended in spite of chemotherapy. The pulmonary metastases of the desmoid fibromata are exceptional and only three cases have been described in literature, with fatal outcome.

Adult↗

PubMed1989

Fracture of the coracoid process of the scapula with acromioclavicular separation. Case report and review of the literature.

A case report of a coracoid fracture of the scapula with acromioclavicular separation is presented. The treatment consisted of surgical reduction and fixation of the acriomioclavicular separation and of the coracoid fracture. After healing of the acromioclavicular separation and the coracoid fracture the left shoulder was asymptomatic with a full range of motion.

Acromioclavicular Joint↗

PubMed1989

[Radiologic and electrodiagnostic viewpoints in the incisura scapulae syndrome].

The authors report on the case of 22 patients who were operated on because of incisura scapulae syndrome. It is pointed out that this problem represents a borderline question and the projected incisura picture as well as the determination of the motor latency of the n. supraspinatus distalis play an important role in the separation of different diseases.

Arm↗

PubMed1989

[Long-term results of surgical treatment of congenital elevation of the scapula].

This study reviews the cases of 21 children with 24 Sprengel's disease, operated from 1961 to 1981. They were classified according to the classification of P. Rigault and J.C. Pouliquen (5 grade I, 12 grade II, 4 grade III). Multiple deformities were associated. The average operative age was 8 years old. The surgical procedure was in 3 cases a partial scapular resection; in 15 a unilateral Woodward and in 3 a bilateral Woodward. The authors have observed 7 post-operative complications, including 2 brachial plexus palsies. The average follow-up is 12 years. Cosmetic results are good in 57.2 per cent, fair in 33.3 per cent and poor in 9.5 per cent. The study of function shows 18 normal shoulders with an average improvement of 51 degrees. Partial resection results seem to be good on mobility and fair on the cosmetic stand point. On the other hand, the results of Woodward procedure are distinctly better. Good results appear to be grade I, operated with Woodward technique and a resection of the most prominent part of the scapula. The authors propose their indications, knowing that Woodward procedure does not solve every problem, and that the existence of associated deformities may go against any surgical correction.

Abnormalities, Multiple↗

PubMed1988

Unicameral bone cyst in the scapula of an adolescent.

Unicameral bone cysts of the scapula have been reported mainly in adult patients. The atypical location of the unicameral bone cyst in a 12-year-old girl presented a diagnostic dilemma. Curettage proved to be an effective method for both diagnosis and treatment of this benign lesion.

Bone Cysts↗

PubMed1988

[Tumorous space occupying lesions of the scapula. An analysis of preoperative assessment of invasion].

The radiographic and histological morphology of 38 tumors lesions of the scapula are analyzed. Osteochondromas (n = 12), chondrosarcomas (n = 7), plasmacytomas (n = 4) and Ewing's sarcomas (n = 3) were the most frequent neoplasms. The radiographically determined growth rates allowed an estimate of the dignity in all cases. Benign lesions were only observed in the first five decades of life, and were mostly located in the scapular blade. Most tumors found in the acromion and in the glenoid region and all lesions diagnosed in the 6th to the 8th decades of life were malignant. In 63.2% of cases correct diagnosis of the type of lesion present was possible on radiographic examination.

Adolescent↗

PubMed1988

Movement of the shoulder after resection of a tumor of the scapula.

Forty-seven patients who had a tumor of the scapula were seen by the Bone Tumour Panel at the Royal National Orthopaedic Hospital, Stanmore, Middlesex, England. Sixteen resections were performed in fourteen patients. Although other authors have discussed the length of survival of one or a few such patients, none, to our knowledge, has reported on postoperative movement of the shoulder. We correlated the type of resection of bone and muscle with the restrictions of postoperative movement. Our patients had an excellent range of postoperative movement, even after subradical resection. The study enabled us to make recommendations for reconstruction of muscle after resection and to determine the functional prognosis.

Adolescent↗

PubMed1986

Ewing's sarcoma of the scapula with metastases to the lung and eye.

A small, round cell tumor of the left scapula was found in a 3-month-old female Caucasian child. The histology was consistent with Ewing's sarcoma. Subsequently, a solitary pulmonary metastasis was excised. Thirty-one months after diagnosis, the child presented with leukokoria and a solitary pleural metastasis. The histology of both was identical to that of the original scapular tumor. G-banded karyotypes of the pulmonary metastasis and the ocular tumor revealed the presence of a balanced translocation, 46,XX, t(11;22)(q24;q12), which supported the original diagnosis of Ewing's sarcoma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1979

Eosinophil granuloma of the scapula.

The writers present a case of eosinophil granuloma of the scapula. This is extremely rare at this site. They describe the clinical course, the unusual radiographic appearances, and the complete functional recovery following local resection.

Adolescent↗

PubMed1978

[Solitary plasmacytoma of the scapula and clavicle].

A 59 year old female patient with a large solitary medullary plasmocytoma of two years duration of the right scapula and clavicle is presented. The patient refused operation and received telecobalt radiation therapy. The palpable swelling and pain disappeared. Bone marrow puncture, blood and urine analyses were quite normal. An individualized therapeutic procedure is recommended for such cases.

Bone Neoplasms↗

PubMed1984

Snapping scapulae: a report of three cases.

Snapping scapula or retroscapular pain is uncommon, and few cases require surgical intervention. In three cases the symptoms were such as to eventually require surgery. No obvious cause was found but excision of the 2 cm of the medial scapular border resulted in prompt and permanent pain relief. Why this should be so is a mystery.

Adult↗