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Winging of the scapula as a complication of first rib resection: a report of six cases.

Long thoracic nerve injury occurred in 6 patients as a complication of first rib resection by the transaxillary route for relief of thoracic outlet syndrome. In a review of 38 patients following 48 first rib resections, this is the second most frequent complication. This complication has rarely been reported in the literature. In 4 patients the long thoracic nerve palsy was transient, and complete recovery of serratus anterior function occurred within 6 months. In one patient, complete recovery followed repair of the long thoracic nerve.

Female↗

[Atypical entrapment syndrome of the distal suprascapular nerve of the incisura scapulae. Case report and overview of the literature].

Entrapment neuropathy of the suprascapular nerve is a rare disease of the peripheral nerve system. Of Mumenthaler's 3465 patients with peripheral nerve lesions, only 15 had suprascapular nerve damage. Since Thompson's and Kopell's first description of suprascapular entrapment neuropathy in 1959, some reports have been published. In the majority of cases the lesion is normally located in the suprascapular notch with clinical involvement of the supra- and infraspinatus muscle. Here we report on an uncommon lesion of the suprascapular nerve with sparing of the supraspinatus muscle in a volleyball player. The current literature will be reviewed. The anatomical basis, examination, differential diagnosis and therapy of this type of entrapment neuropathy will be discussed.

Adult↗

[The scapula: rare localization of osteochondroma].

The authors demonstrate their 6 cases of scapular exostoses which were operated on between 1973 and 1993 at the Orthopaedic Department of the Medical University of Pécs. Results of the surgery with a mean five year follow up are discussed, and the literature data of incidence, diagnosis and treatment are reviewed. With resection of the osteochondroma good results were achieved in all of the cases.

Adolescent↗

The origin of the long head of the biceps from the scapula and glenoid labrum. An anatomical study of 100 shoulders.

We dissected 105 cadaveric shoulders to study the origin of the tendon of the long head of biceps, and examined histologically the interrelationship between the tendon, the supraglenoid tubercle and the superior labrum of the glenoid. In all specimens approximately 50% of the biceps tendon arose directly from the superior glenoid labrum with the remainder attached to the supraglenoid tubercle. The main labral origin was from the posterior labrum in more than half of the specimens, and in a quarter this was the only labral attachment. On the basis of the biceps attachment to the anterior or posterior labrum, we distinguished four types of origin. These normal anatomical variations are significant for arthroscopic diagnosis and may help to explain the various patterns of injury seen in partial or complete detachment of the tendon, the labrum or both.

Cadaver↗

[Reconstruction of the mandibular symphysis using a revascularized free flap of the scapula. Surgical technic].

In cases of surgically removed mandibular symphysis malignancies, the bone and mouth floor were reconstructed using osteo-musculo-cutaneous flaps. In our experience, the latter provide the best results. Removed in dorsal decubitus, they allow floor replacement. During the dissection of the tumor site, we also preserve labial and chin structures, which favours a good restoration of phonation and swallowing.

Anesthesia↗