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At least 307 records · Page 17Linked to original sources
PubMed1984

Traumatic lateral displacement of the scapula: a radiographic sign of neurovascular disruption.

Scapulothoracic dissociation, as manifested by lateral displacement of the scapula and acromioclavicular separation, is a previously unreported injury in which there is a complete disruption of the scapulothoracic articulation without an overlying partial or complete amputation through the soft tissue. Associated with the disruption of the scapulothoracic articulation are injuries to the brachial plexus and the subclavian artery and vein; multiple open and closed fractures of the ipsilateral upper extremity are often present also. In the patient with severe multiple injuries, scapulothoracic dissociation may not be recognized immediately, with potentially fatal consequences. In this paper we present the cases of three patients with radiographic and pathological evidence of scapulothoracic dissociation and review the literature on related injuries.

Accidents, Traffic↗
PubMed1984

[Therapeutic remarks on the congenital elevation of the scapula. Apropos of 16 cases].

The authors review a series of 16 cases of congenital high scapula including 4 bilateral cases. The pathological aspects are detailed including investigations for scapular hypoplasia (3 cases), omovertebral bone (7 cases), loco-regional muscular anomalies (5 cases), and various deformities of the cervical spine (present in all cases). The entire spine and the thoracic cage was examined in all cases. The Woodward procedure was performed with some modifications described in the text. The operative results in 3 cases were judged to be failure based on cosmetic and functional criteria. The age of the patients at operation and the presence of an omovertebral bone did not influence the results, however, the presence of important deformities of the cervical spine had a poor prognosis. The authors insist on the loco-regional character of the deformity and on the importance of the reorientation of the scapulo-humeral joint. Results were judged on cosmetic and functional criteria with 79% excellent or fair results.

Abnormalities, Multiple↗
PubMed1981

Congenital elevation of the scapula. Surgical correction by the Woodward procedure.

We reviewed the cases of eleven patients with congenital elevation of the scapula who were treated by the Woodward procedure. A discussion of the characteristic findings, associated congenital anomalies, indications for operation, and surgical techniques, and a review of the literature, also are presented. The average postoperative increase in combined shoulder abduction in the eleven patients was 29 degrees. However, if preoperative abduction was less than 120 degrees (five patients), the average increase in motion was 50 degrees. The average scapular lowering was 1.6 centimeters. The cosmetic results were rated as excellent or good in 82 per cent of the patients. It is significant, however, that in more than 60 per cent of the patients unsightly surgical scars developed. The importance of the often-underemphasized rotational component of Sprengel's deformity is stressed, as well as the importance of the meticulous surgical technique and attention to detail that are essential for the best results.

Adolescent↗
PubMed1995

Does the area of the glenoid cavity of the scapula show sexual dimorphism?

The area of the glenoid cavity was determined in 214 scapulae (114 male, 100 female). Mean values of 9.87 cm2 for the males and 7.18 cm2 for the females were found. Presentation of the values as a histogram showed a bimodal distribution indicating sexual dimorphism, which was confirmed by the Mann-Whitney-Wilcoxon test for unconnected samples. The area of the cavity can therefore be used for the sexing of a skeleton. With the described method 60% of males but only 36% of females can be graded unambiguously.

Anthropometry↗
PubMed1993

Partial scapulectomy for snapping scapula syndrome.

Snapping scapula is a relatively uncommon source of scapular pain. A survey of the literature reveals a variety of causes of this syndrome. In the case presented here, the symptoms of this syndrome were immediately and permanently relieved by surgical excision of scapular abnormalities and part of the medial scapular border.

Adult↗
PubMed1996

The scapula: coracoid, acromial, and avulsion fractures.

Fractures of the coracoid and acromial processes and avulsion fractures of the scapula are uncommon with the vast majority being managed quite successfully nonoperatively. On occasion, however, these injuries may be significantly displaced and of functional importance, thus making surgical management a consideration. Diagnosis is radiographic. Due to the complex anatomy in the area, CT scanning is often necessary to detect and accurately define these injuries. The various fracture patterns that occur as well as mechanisms of injury are described. Surgical indications are detailed as are the various fixation techniques that may be employed or required. The postoperative rehabilitation program is as important as the surgical procedure.

Acromion↗
PubMed1977

Unicameral bone cyst in the scapula.

This is a case report of a 21 year old man with a unicameral bone cyst of the scapula. The occurrence here, as in other flat bones, is rare. The unusual location presents a diagnostic problem, but as in other flat bones, the prognosis after treatment by bone grafting is very good.

Adult↗
PubMed1998

[Percutaneous treatment of an osteoid osteoma of the scapula using a laser under scanner control].

The authors report a new therapeutic modality used in a patient with an osteoid osteoma of the scapula. The young patient complained of pain increasing over the last 4 years and not responding to medical therapy. The nidus was successfully destroyed by percutaneous laser photocoagulation under CT guidance. Clinical improvement was manifest after 72 hours and the patient remained asymptomatic at 8 months follow-up.

Adult↗
PubMed1998

Ipsilateral omovertebral bones in the levator scapulae muscle and the rhomboid muscle in a Sprengel deformity: case report.

Our interest was stimulated by the uncommon case of a 4-year-old girl who presented a Sprengel deformity associated with two omovertebral bones on the same side. The first omovertebral bone was situated in the levator scapulae muscle and the second omovertebral bone was lying in the rhomboid muscle. The removal of these two bones was combined with a Woodward procedure to obtain a good correction.

Axis, Cervical Vertebra↗
PubMed1998

Congenital elevation of the scapula (Sprengel's deformity).

A case of Sprengel's deformity (congenital elevation of the scapula) in a 4-year-old boy, with a major cosmetic defect and compromised shoulder function, especially on abduction, is presented. The boy was operated on by Green's technique, with excellent cosmetic and functional result. Although Woorward's operative technique has generally been preferred in the treatment for Sprengel's deformity, the result obtained showed Green's procedure to be a satisfactory choice in this patient.

Child, Preschool↗
PubMedDate not supplied

Tubercular osteitis of the spine of the scapula.

At present the incidence of osteoarticular tuberculosis is increasing in the western world. The authors describe a case of tubercular osteitis of the scapula. Surgical treatment in association with antitubercular therapy obtained excellent results.

Adult↗
PubMed1997

A scapula with an unreported canal.

During the practical lectures in our department, we encountered an abnormality on the left scapula of an adult human. In this case, an elongated canal was found just posterior and inferior to the coracoid process and the scapular notch was not observed on this bone. Knowing about the anatomic variations of this region may have an importance for the surgeons.

Adult↗
PubMed1999

Bone tumors of the coracoid process of the scapula.

Bone tumors of the coracoid process of the scapula are rare, and diagnosis and treatment often are delayed. The records of 18 patients with bone tumors of the coracoid process were reviewed. Histologic types included eight cases of ordinary chondrosarcoma, three cases of dedifferentiated chondrosarcoma, two cases of osteoid osteoma, and one case each of osteosarcoma, plasmacytoma, lymphoma, giant cell tumor, and aneurysmal bone cyst. All 18 patients had shoulder pain, and eight of them had been treated with steroid injections for nonneoplastic conditions. Radiologically, chondrosarcoma did not always show clear cortical destruction, and one giant cell tumor had features mimicking those of chondrosarcoma. Five patients (three with dedifferentiated chondrosarcoma, one with chondrosarcoma, one with plasmacytoma) died of disease. The coracoid process was the site with a markedly high proportion of chondrosarcomas. Bone tumors of the coracoid process may be difficult to detect on plain radiographs. In the patient with persistent shoulder pain unresponsive to the selected treatment, additional imaging studies should be considered to eliminate the possibility of a bone lesion.

Adolescent↗
PubMed2003

Selective peripheral denervation of the levator scapulae muscle for laterocollic cervical dystonia.

Laterocollis, as a symptom of idiopathic cervical dystonia may be due to abnormal contraction of the levator scapulae muscle (LSM). The purpose of this study is to define the effects of selective peripheral denervation of LSM in patients with laterocollic cervical dystonia.The clinical records of 10 patients who underwent LSM denervation for laterocollic torticollis were reviewed. Preoperatively, all patients showed sustained lateral tilt of the head and elevation of the shoulder. Abnormal contraction of LSM was observed and the muscle was denervated surgically in the posterior cervical triangle. The mean age at operation was 38.4 years (range, 20-58 years) and the mean duration of the symptom ranged from 14 to 80 months (mean, 41months). The postoperative follow up ranged from 6 to 72 months (mean, 29.4months). The cervical dystonia rating score of Tsui was 10.8 on average before the operation, and the postoperative follow up score was 1.3. According to the changes of the rating score, success rates, including excellent and good results, were 40% and 60%, respectively. Five patients (50%) postoperatively showed transient dysaesthesia in the neck. There was no disturbance of shoulder elevation or arm raising. When abnormal contraction of LSM is responsible for laterocollis in patients with cervical dystonia, selective peripheral denervation of this muscle is a safe and effective procedure for alleviation of the symptom.

Adult↗
PubMedDate not supplied

The acromion: morphologic condition and age-related changes. A study of 420 scapulas.

Two hundred ten specimens (420 scapulas) from the Hamann-Todd Osteological Collection at the Cleveland Museum of Natural History were evaluated to determine the influence of age on acromial morphologic condition. Equal numbers of specimens from female and male and black and white subjects were evaluated. The length, width, and anterior thickness of the acromion and the acromial facet of the acromioclavicular joint were measured with digital calipers, examined visually, and evaluated radiographically. Distribution of acromial morphologic types was type I, (flat) 32%, type II (curved), 42%, and type III (hooked), 26%. Analysis of the data revealed no consistent, statistically significant impact of age on morphologic condition. The incidence of os acromiale was 8% (17 of 210), with 7 (41%) of 17 specimens having bilateral involvement. Mean acromial dimensions in men were length = 48.5 mm, width = 19.5 mm, and anterior thickness = 7.7 mm. Mean dimensions in women were length = 40.6 mm, width = 18.4 mm, and thickness = 6.7 mm. Multiple regression analysis revealed no significant changes in any dimension with increasing age. Observation of the acromial facet of the acromioclavicular joint revealed 49% were medially inclined, 48% were vertically inclined, and only 3% were laterally inclined in relationship to the sagittal plane. A statistically significant age-related increase in degenerative changes was noted. Anterior acromial spur formation as determined by visual inspection of the acromion was observed in 7% of specimens from patients younger than 50 years compared with 30% of specimens from patients older than 50 years (p < 0.05). Spur formation on the anterior acromion is an age-dependent process. Acromial morphologic condition as evaluated by outlet radiographs is independent of age and appears to be a primary anatomic characteristic. The variations seen in acromial morphologic condition are not acquired from age-related changes and spur formation and thus contribute to impingement disease independent of and in addition to age-related processes.

Acromioclavicular Joint↗
PubMed1992

Reconstruction of a complex defect of the hand with two distinct segments of the scapula and a scapular fascial flap transferred as a single transplant.

To repair multiple defects of the metacarpal bones in combination with skin defects, a combined scapular free flap on a single vascular pedicle--the subscapular artery and the accompanying veins--can be used successfully. This flap includes two distinct bone segments of the lateral border of the scapula and a scapular fascial flap. Because of its long and mobile vascular pedicle, such a transplant can be used for one-stage reconstruction of the first and other metacarpal bones of the long fingers of the hand. The scapular fascial flap included in the transplant provides good functional and aesthetic results in combined injury of the skin of the hand.

Accidents, Occupational↗
PubMed2001

Osteomuscular latissimus dorsi scapula flap to repair chronic, posttraumatic osteomyelitis of the lower leg.

Fractures of the lower leg with soft-tissue loss may be complicated by osteomyelitis. Many treatment plans offered in the past have included the use of vascularized bone, but the soft tissue that accompanied the bone was sometimes less than ideal in quality as well as quantity. This study presents a one-step method for the surgical treatment of chronic, posttraumatic osteomyelitis that includes (1) radical debridement of the area affected by osteomyelitis, (2) use of revascularized bone for stabilization of the affected area, and (3) well-vascularized soft-tissue cover for the defect. The use of an osteomuscular latissimus dorsi scapula flap is described and illustrated by descriptions of five operations performed by the authors' department in Salzburg, Austria. The resultant healing of the bone was comparable to the primary healing of a fracture.

Adult↗
PubMed2003

Levator scapulae and rhomboid transfer for paralysis of trapezius. The Eden-Lange procedure.

Spinal accessory nerve palsy leads to painful disability of the shoulder, carrying an uncertain prognosis. We reviewed the long-term outcome in 16 patients who were treated for pain, weakness of active elevation and asymmetry of the shoulder and the neck due to chronic paralysis of the trapezius muscle, as a result of nerve palsy. Of four patients who were treated conservatively, none regained satisfactory function, although two became pain-free. The other 12 patients were treated operatively with transfer of the levator scapulae to the acromion and the rhomboid muscles to the infraspinatus fossa (the Eden-Lange procedure). At a mean follow-up of 32 years, the clinical outcome of the operatively treated patients was excellent in nine, fair in two, and poor in one patient, as determined by the Constant score. Pain was adequately relieved in 11 and overhead function was restored in nine patients. Pre-operative electromyography had been carried out in four patients. In two, who eventually had a poor outcome, a concomitant long thoracic and dorsal scapular nerve lesion had been present. The Eden-Lange procedure gives very satisfactory long-term results for the treatment of isolated paralysis of trapezius. In the presence of an additional serratus anterior palsy or weak rhomboid muscles, the procedure is less successful in restoring shoulder function.

Accessory Nerve Injuries↗