[Percutaneous treatment of an osteoid osteoma of the scapula using a laser under scanner control].
Explore the source record for details and available documents.
Adult↗
SEARCH · Search PubMed
Results for “SCAPULA”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Sprengel's deformity].
The authors deal with etiology, pathological anatomy and clinical finding in inborn high-riding scapula--the so-called Sprengel deformity. What is the best treatment tactics? Is the conservative treatment more suitable than the surgical one, or vice versa? By comparing their own experience with the data in the specialized literature the authors advocate a strictly individualized approach to each affected patient. After determining the diagnosis of Sprengel deformity it is necessary to evaluate the position of the scapula and the extent of the limitation of the range of motion of the respective shoulder-girdle. At the same time it is essential to consider the ability of the child and his parents to cooperate in the period of the postoperative rehabilitation. The rehabilitation carried out properly in the postoperative period is equally important as the perfect performance of the surgery. In more severe grades of affection combined with greater functional limitation of the ipsilateral shoulder the authors recommend the surgical treatment using the Green procedure with additional subperiosteal osteotomy of the ipsilateral clavicle (morcellation). The aim of the operation consists in the reduction of the scapula with simultaneous extraperiosteal release of most muscles inserted on the scapula. At the same time the os omovertebrale, if present, is always removed. The congruency of the anterior surface of the scapula and the thoracic wallis achieved by the resection of the supraspinatus part of the scapula. The proper position of the reduced scapula is ensured both by the reinsertion of muscle insertions to new, functionally more advantageous parts and by the fixation of the interior angle of the scapula in a newly created "pocket" in m. latissimus dorsi. Immediately after operation the proper position of the scapula is ensured by wire cerclage, distally anchored to the contralateral spica cast. The authors evaluate a group of 7 patients operated on at the Orthopaedic Clinic of the Institute for Further Education of Physicians, Teaching Hospital at Bulovka in Prague in the period of 1980-1987. Ensuing from the evaluation is the fact that in all deformities of III grade according to Cavendish the results achieved were satisfactory. On the other hand, the deformities of IV grade are difficult to treat even by operation. Only in one case the result was partially successful. In the conclusion the authors recommend a timely screening of the deformity, its timely operation (up to the age of 4 years) and indication carefulness in elder children.
Child↗
Is there any effect of suprascapular notch type in iatrogenic suprascapular nerve lesions? An anatomical study.
This anatomical study, which is aimed at assessing the effect of suprascapular notch type in iatrogenic suprascapular nerve lesions in surgical interventions, was conducted in two stages. A hundred dry scapulas and 20 scapulas of 11 cadavera were classified according to Rengachary. The point of measurement was determined medially as the deepest point of suprascapular notch and laterally as supraglenoid tubercle in dry scapulas and anchor of biceps in cadavera. It was found that in the measurements made in dry scapulas, notch Type-IV scapulas, despite not being statistically significant, had the lowest average (2.35 cm), with minimum and maximum values of 2.1 cm and 2.78 cm respectively, when compared to other scapula types. It was found in the cadavera study that the measurements of one Type-IV scapula and one Type-V scapula were lower than the other types. Determination of the notch type in the rotator-cuff tears--especially in massive and retracted tears where supraspinatus has to be released from the fossa--may be helpful in avoiding iatrogenic nerve lesion.
Adult↗
Scapular thickness--implications for fracture fixation.
The purpose of this study was to measure and map scapula osseous thickness to identify the optimal areas for internal fixation. Eighteen (9 pairs) scapulae from 2 female and 7 male cadavers were used. After harvest and removal of all soft tissues, standardized measurement lines were made based on anatomic landmarks. For consistency among scapulae, measurements were taken at standard percentage intervals along each line approximating the distance between two consecutive reconstruction plate screw holes. Two-mm-diameter drill holes were made at each point, and a standard depth gauge was used to measure thickness. The glenoid fossa (25 mm) displayed the greatest mean osseous thickness, followed by the lateral scapular border (9.7 mm), the scapula spine (8.3 mm), and the central portion of the body of the scapula (3.0 mm). To optimize screw purchase and internal fixation strength, the lateral border, the lateral aspect of the base of the scapula spine, and the scapula spine itself should be used for anatomic sites of internal fixation of scapula fractures.
Aged↗
Kinematic analysis of the cat shoulder girdle during treadmill locomotion: an X-ray study.
A quantitative kinematic analysis of the movements of the shoulder girdle in the three dimensions of space during treadmill locomotion (velocity range 0.33-1.2 m/s) was performed in two cats. Since the movement patterns of the scapula and the humeroscapular joint can only vaguely be estimated through the overlying skin we used implanted metal spheres placed on the scapula in combination with three-dimensional pulsed X-ray cinematography (time resolution 20 ms) to reconstruct the excursions of the scapula, the humerus and the elbow and to calculate the respective angular amplitudes and velocities. The movements of the scapula relative to the Th4 spinous process consist of four major components:(i) a monophasic flexion (caudocranial movement of glenoid fossa during swing)/extension (craniocaudal movement of the glenoid fossa during stance) sequence, the fulcrum for which sequence is situated near the vertebral border of the scapula at the medial elongation of the scapular spine; (ii) a vertical monophasic up/down sequence of the fulcrum relative to the trunk, the highest vertical position being reached during mid-stance and the lowest vertical position during mid-swing; (iii) a biphasic abduction/adduction sequence during swing and during stance respectively; and (iv) small rotations along the scapular spine. The trajectory recordings of the scapula indicate that the scapula yields relative to the trunk under the body weight after ground contact. The angular excursions of the humeroscapular joint consist of : (i) a flexion/extension sequence during swing, a yield after ground contact and a final extension at the end of stance; (ii) an adduction and outward rotation during the early swing phase flexion; (iii) an abduction and inward rotation during the late swing phase extension; and (iv) an adduction during the yield with only minor rotations during the whole stance phase. The movement patterns are discussed in view of the muscular synergies necessary to guide the scapula and the humerus during stance and swing, and in relation to the implications for the organization of these patterns in spinal neuronal systems.
Animals↗
Prenatal ultrasonographic diagnosis of Sprengel's deformity.
Sprengel's deformity is the congenital failure of descent of the scapula. Eulenburg first described this in 1863. Sprengel described 4 cases in 1891; hence, the anomaly has been called Sprengel's deformity. Other terms for this entity are Sprengel's anomaly, Sprengel's shoulder, congenital high scapula, and undescended scapula. In this entity, varying degrees of scapula elevation and scapula hypoplasia occur. In approximately one third of cases, Sprengel's deformity is accompanied by an accessory ossicle, the omovertebral bone, which articulates between the medial border of the scapula and 1 or more of the cervical vertebrae. In the absence of an omovertebral bone, a fibrous fascial sheath extends from the superior angle of the scapula to the spinous process, the lamina, or the transverse process of 1 or more lower cervical vertebrae. This fixation accounts for the medial position and elevation of the scapula. I report a case of prenatal ultrasonographic detection of Sprengel's deformity.
Adult↗
The shoulder in patients with muscular dystrophy.
Shoulder weakness and instability are not usually a major part of the clinical picture of muscular dystrophies. Problems usually do not arise until the patient is wheelchair bound, at which time assistive appliances may be required. The majority of orthopaedic intervention is confined to the rare facioscapulohumeral dystrophy. Facioscapulohumeral dystrophy causes muscular weakness of the face, shoulder girdle, and upper arm with selective sparing of the deltoid muscle. This leads to scapular winging and a marked decrease in flexion and abduction of the shoulder. As the muscles stabilizing the scapula become involved, the scapula starts to wing. The deltoid is spared, but its action is wasted because of the unstable scapula. The deltoid contracts and the arm attempts to move in a normal fashion, but because the scapula is no longer stable, it wings and rotates under the forces of the long lever arm of the upper limb and scapula complex. Mechanical fixation of the scapula to the thoracic wall provides a stable fulcrum on which the deltoid can exert its powerful action on the humerus and abduct the arm without rotation of the scapula. Twenty thoracoscapular fusions were performed on 13 patients. Ten patients (14 shoulders) were available for long term followup. The long term results showed that this operation is successful in achieving stability of the scapula, while greatly improving function and cosmesis. Although the course of this type of muscular dystrophy is variable, the benefits of surgery have not deteriorated with progression of the disease during a maximum followup of 44 years.
Adolescent↗
The morphometry of the coracoid process - its aetiologic role in subcoracoid impingement syndrome.
Anatomical morphometric studies of the coracoid process and coraco-glenoid space were carried out on 204 dry scapulae. No statistically significant correlations were found between length, or thickness of the coracoid process, prominence of the coracoid tip, coracoid slope, coraco-glenoid distance, or position of the coracoid tip with respect to the uppermost point of the glenoid. These anatomical characteristics were independent of the dimensions of the scapulae. Three configurations of the coraco-glenoid space were identified. Type I configuration was found in 45% of scapulae and Type II and Type III, in 34% and 21% of specimens, respectively. The lowest value of the coraco-glenoid distance were seen in Type I scapulae. Morphometric characteristics which might predispose to subcoracoid impingement were found in 4% of Type I scapulae. A total of 27 scapulae, nine with each type of configuration were submitted to CT scanning. Scapulae with a Type I configuration were found to have low values for the coraco-glenoid angle and coracoid overlap, which are known to be associated with a short coraco-humeral distance. Subjects with a Type I configuration, and severe narrowing of the coraco-glenoid space, appear to be predisposed to coraco-humeral impingement. These morphometric characteristics may be easily evaluated on CT scans.
Adult↗
X-ray kinematic analysis of shoulder movements during target reaching and food taking in the cat.
Co-ordinate movements around the shoulder are essential during reaching movements. We performed a quantitative kinematic analysis of movements of the shoulder girdle: three-dimensional X-ray frames (time resolution 20 ms) were recorded during the target-reaching and food-taking paradigm in five cats either sitting (n = 4) or standing (n = 1) in front of a food well. Movements of the scapula consisted of a flexion of the scapula (anteversion of the glenoid) followed by flexion of the gleno-humeral joint (decrease in the angle between the scapular spine and humerus). In the sitting animals, the gleno-humeral flexion reversed to extension some 120 ms before object contact, while in the standing animal flexion continued during the ongoing scapular flexion. In both cases, the scapula was nearly horizontal at the end of target reaching. The fulcrum for scapular movements was located near the vertebral border of the scapula at the medial elongation of the scapular spine. No major translational components of the fulcrum with respect to the trunk were found during reaching. Together with full flexion of the scapula, this reduces the number of degrees of freedom considerably and thereby probably simplifying the specification of the end-point of the limb chain. End-point specification is further supported by rotational movements of the scapula. In the sitting animal, the amplitude of inward rotation along the long axis of the scapula was around 20 degrees, while it was much more variable in the standing animal, reflecting more variable starting positions. We hypothesize that the glenoid is used to 'foveate' the target object.
Animals↗
The lennie test for measuring scapular position in healthy young adult females: a reliability and validity study.
Normal scapular rest position is neither adequately described nor agreed upon by authorities. The purpose of this study was to devise and describe a reliable and valid test (the Lennie Test) to measure scapular position, including normal scapular rest position. Fifteen healthy females (age 19-21 years) participated in the study. Horizontal and vertical scapular position in the frontal plane was quantified by three different investigators using a scoliometer and caliper. Same-day radiographs were used to validate scapular position surface measurements. The medial borders of the scapulae were found to be parallel to the thoracic midline. The scapulae were on average 17.19 +/- 1.85 cm apart (at the level of the root of the scapulae) with the dominant arm scapula being on average 0.49 +/- 0.74 cm lower than the nondominant scapula. This difference in height between scapulae was not statistically significant (p > .01). Correlation coefficients between skin surface and radiograph measurements of scapular position ranged from .43 to .82. Intertester intraclass correlation coefficients for surface measurements of scapular position ranged from .64 to .86. The Lennie Test was found to have moderate to high intertester reliability and to provide an accurate measurement of the anatomical location of the scapulae based on X-ray verification. Surface landmark measurements for scapular position were on average within 0.56 cm and within 1.7 degrees of the measurements made from X-rays for linear and angular position, respectively. We propose the use of the Lennie Test in populations, healthy or otherwise, where scapular position needs to be objectively measured.
Adult↗
Acromial morphology: effects of suboptimal radiographs.
Acromial morphology is one of the important factors related to rotator cuff pathology, especially if there is acromial encroachment onto the supraspinatus tendon. This is the rationale for many surgeons performing an acromioplasty, based on preoperative radiographs, in their treatment of rotator cuff disease. However, geometric measurements of the acromion are dependent on the radiographic view, and suboptimal radiographs of the scapula might bias the acromial morphology on the radiographs. Our objective was to study the effect of suboptimal lateral-view radiographs of the scapula on 6 acromial angles, which have been correlated with rotator cuff pathology, by use of a computational method. Anatomic landmarks were digitized on 12 cadaveric scapulae via a spatial linkage system. A coordinate system based on the scapula was then created that allowed projection of the anatomic landmarks on the sagittal plane and simulated the optimal lateral-view radiograph of the scapula. By rotating the coordinate system in the coronal plane (cranial and caudal projections) and axial plane (anterior and posterior projections) with 5 degrees, 10 degrees, 15 degrees, and 20 degrees increments, 16 suboptimal lateral-view radiographs of the scapula were simulated. Significant differences in the 6 acromial angles (P < .01) between the optimal and suboptimal lateral-view radiographs of the scapula were found in almost every cranial and caudal projection. Rotating the projection in the axial plane did not significantly affect the acromial angles (P > .05) up to 20 degrees of rotation in the anterior and posterior direction. Of the 6 different acromial angles, the acromial slope was least affected when the projection was varied. In contrast, the anterior slope of the acromion was highly affected by errors in the projection.
Acromion↗
Variability of measurement of glenoid version on computed tomography scan.
The purpose of the study was to determine the variability of measurement that might occur with rotation of the scapula in the coronal plane when computed tomography scanning is used. Ten dry scapula specimens had 4 sets of computed tomography scans performed at +20 degrees, +10 degrees, neutral, and -10 degrees of scapula rotation. The angle of glenoid version was then measured according to the technique of Friedman. The measured value for glenoid version was noted to vary by as much as 10 degrees on the same specimen with minor rotation of the scapula. This result occurred because of differences in the curvature of the vertebral border of the scapula. The measured angle of glenoid version was most likely to vary with rotation of the scapula 10 degrees downward (i.e., glenoid articular surface facing 10 degrees upward). For accurate and reproducible measurement of the glenoid version, it is essential that in the scout view the glenoid orientation is neutral (i.e., glenoid surface is perpendicular to the plane of the computed tomography cut).
Humans↗
Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors.
OBJECTIVE: To determine the effect of trunk sitting posture on scapular kinematics during humeral elevation by using skin-mounted electromagnetic tracking sensors. DESIGN: Repeated-measures design contrasting scapular kinematics in 2 different sitting postures. SETTING: A biomechanics laboratory in Hong Kong with a real-time, 3-dimensional electromagnetic tracking device for measuring movements of the scapula. PARTICIPANTS: A sample of 16 healthy adults (12 women, 4 men; age, 21.6+/-3.92y) with full, pain-free shoulder range of motion and no history of shoulder pathology. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Movements of the scapula were measured while each subject performed humeral elevation in an upright seated position and a slouched seated position. RESULTS: In both postures, posterior tip, lateral and upward rotation of the scapula, and lateral rotation of the humerus were observed during humeral elevation. When the slouched posture was adopted, there were significant decreases in the posterior tip and lateral rotation of the scapula, but there was no significant change in the magnitude of the upward rotation of the scapula. CONCLUSION: Increased thoracic kyphosis significantly alters the kinematics of the scapula during humeral elevation.
Adult↗
Reconstruction following radical maxillectomy with flaps supplied by the subscapular artery.
The authors present their experience of 27 cases with repairs of defects following radical maxillectomies with free flaps. A total of 28 flaps were used (five latissimus dorsi, six scapula, 16 combination flaps of scapula and latissimus dorsi and one combination of scapula, latissimus dorsi and serratus anterior flap). Only one scapula flap was completely lost and in three cases where a combination of scapula and latissimus dorsi flap was used, partial necrosis of one component occurred. The authors first choice for reconstruction is a scapula bone flap raised on the angular artery combined with the latissimus dorsi flap. The combination of flaps with a long pedicle and of the bony and muscular components provides the surgeon with the option of customizing the flap to meet individual patient needs. For intraoral closure the authors prefer the latissimus dorsi muscle which rarely requires secondary procedures for prosthesis placement following epithelialization and atrophy. The main disadvantage of the flap is the difficulty of two teams working simultaneously, thus increasing the average operating time. All postoperative corrections and prosthetic rehabilitation should be postponed for at least 2 months following surgery because of postoperative swelling.
Adolescent↗
[Operative treatment of congenital upward displacement of the shoulder blade].
In congenital elevation of the scapula the scapulothoracic movements and the patient's cosmetical appearance are affected. The aim of a number of operative procedures is the improvement or removal of this conditions. Between 1958 and 1978 15 patients with congenital elevation of the scapula were operatively treated by resection of the supraspinous portion of the scapula with or without relocating the scapula in a more caudal position, or in the method of König. 5 cases had a Grade-3 deformity, 9 cases a Grade-2 deformity and one case a Grade-1 deformity, measured in the technique of Rigault. By resection of the supraspinous portion of the scapula with mobilization of the scapula (6 cases) a mean caudalization of 2.7 cm. and a mean improvement in shoulder abduction of 32 degrees could be achieved. The procedure of König resulted in a mean scapular caudalization of 2.9 cm. and a mean improvement in shoulder abduction of 26 degrees. No important difference in the endresult could be found between the two operative procedures because of nearly the same pre-operative grading distribution of deformity. Only the partially unsightly surgical scars were dissatisfying.
Child↗
Stability of dental implants in microvascular osseous transplants.
Microvascular iliac crest and scapula transplants have been used in reconstruction of the lower jaw following tumor surgery. It has only been with the insertion of dental implants that a satisfactory prosthetic rehabilitation of the patient has been achieved. For this study, a follow-up of 38 patients with lower jaw tumors was carried out. The patients had been treated with partial resection of the lower jaw and neck dissection with microvascular iliac crest transplants (n = 20) or microvascular scapula transplants (n = 18); this was followed with dental implants (n = 143) in the region of the transplants or the local lower jaw. One hundred thirty-nine of the 143 dental implants were loaded by prosthetic superstructures. In all patients, the implant situation was evaluated on average 2 years 5 months after implantation. Periotest values, periimplant probing depths, and contact bleeding were registered, and the extent of periimplant bone loss was defined radiographically. The clinical situation in the region of the implant was compared for both types of implants and also with the nonresected lower jaw. The average Periotest values were within the normal range for all groups. In one scapula implant, however, a better average of Periotesting, -3.3, was found compared with implants of the iliac crest with Periotest values of -0.7. A measurement of -2.1 was found for the local lower jaw, similar to that of scapula implants. Pathologic probing depths were found for all three compared groups. The radiographically determined vertical loss of bone was the same for all three groups, on average 1 mm at 27 months postoperatively. The highest incidence of sulcus bleeding was found in the scapula implant group. Thus, it can be stated that the scapula transplants provide a similar transplant site to local lower jaw bone, whereas implants in iliac crest transplants show lesser bony stability. Periimplant soft-tissue conditions are worse for both types of transplants compared with local tissue of the lower jaw.
Dental Implantation↗
An ex vivo mechanical evaluation of single versus double semitubular plate fixation of a transverse distal-third scapular osteotomy in the dog.
OBJECTIVE: To compare single versus double semitubular plate fixation for scapular body fractures. STUDY DESIGN: Ex vivo mechanical study. SAMPLE POPULATION: Eighteen paired cadaveric canine scapulae. METHODS: Transverse scapular body osteotomies were created in the distal third of 18 pairs of scapulae. One scapula of each pair was repaired with a single plate, whereas the contralateral scapula was repaired with 2 plates. Initial strength and stiffness of the constructs were measured in 10 pairs of scapulae. Eight pairs of scapulae underwent cyclic loading and then were subjected to failure testing. RESULTS: Double-plate fixation was significantly stronger (3,899 +/- 632 N) but not stiffer (614 +/- 130 N/mm) than the single-plate fixation (3,238 +/- 935 N and 537 +/- 202 N/mm, respectively). Cyclic loading variables were not significantly different between the 2 methods of fixation. After cyclic loading, double-plate fixation was significantly stronger (2,916 +/- 618 N) than single-plate fixation (2,347 +/- 495 N). There was no significant difference (P =.11) in stiffness between double- versus single-plate fixations: 734 +/- 247 N/mm and 595 +/- 139 N/mm, respectively. CONCLUSIONS: Double-plate fixation was generally stronger and stiffer than single-plate fixation. Because all constructs failed at loads that greatly exceeded those estimated to occur clinically, any difference between the 2 methods of fixation probably is not clinically relevant. CLINICAL RELEVANCE: Single-plate fixation may be of sufficient strength for fixation of scapular body fractures.
Animals↗
Movements of the forelimbs of the cat during stepping on a treadmill.
In normal cats stepping on a treadmill an analysis has been made of movements of the scapula, shoulder, elbow, wrist and digits. The scapula is capable of making large and complicated movements over the rib cage. In locomotion they may be resolved into a cyclical, similunar movement of the glenoid cavity in the parasagittal plane of the cat's body. The movements of the scapula are rather constant over a wide range of velocities. They most resemble those of the hip which also shows a delay in the onset of extension and no yield phase. It is suggested that movements of the scapula have a high priority in the execution of locomotion in the forelimbs. The movements at the shoulder tend to parallel those of the elbow. The terms of palmar flexion and dorsiflexion are retained for the movements at the wrist and digits. The rapid phase of palmar flexion corresponds with the flexion phase at the elbow, and the phase of dorsiflexion with the first extension phase at the elbow. Palmar flexion during the second and third extension phases of the more proximal joints would appear to be initiated by contact of the foot with the ground. The sequences of movement at the wrist and digits allow a comparison of the roles of flexor and extensor muscles of the forearm during locomotion and the flexion reflex, which is compatible with the functional and anatomical organization of cervicothoracic segments. With exception of extension at the scapula the movements of the elbow provide an index of the onsets of flexion and extension at the other joints of the forelimb. Modifications are suggested for the Phillippson step cycle of both forelimbs and hindlimbs to include the delayed onset of extension at the scapula and hip and the particular movements of the wrist, digits and toes.
Animals↗