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At least 1,009 records · Page 56Linked to original sources
PubMed2003

Glenoid inclination is associated with full-thickness rotator cuff tears.

Anatomic factors, such as a hooked acromion, have been associated with rotator cuff disorders. Orientation of the glenoid relative to the scapula has been implicated in shoulder instability, but it has not been linked to rotator cuff disorders. The purpose of the current study was to test the hypothesis that superior inclination of the glenoid is associated with full-thickness rotator cuff tears. Glenoid inclination angles were measured from 16 shoulder radiographs of a convenience sample of eight cadavers in which one shoulder had an intact rotator cuff and the other shoulder had a full-thickness rotator cuff tear. Glenoid inclination angles for shoulders with rotator cuff tears were compared with contralateral normal shoulders using nonparametric statistical analysis. The glenoid inclination angle was greater in cadaver shoulders having full-thickness rotator cuff tears (98.6 degrees ) than in shoulders without tears (91.0 degrees ). A second experiment was done to assess the reliability of using 34 Grashey view radiographs from a clinical population to measure glenoid inclination angle. A method to measure the glenoid inclination on Grashey views was tested and was found to correlate with the inclination angles measured on cadaveric scapulae. Intrarater reliability of measurements from clinical Grashey views was 0.93, and interrater reliability was at least 0.88.

Aged↗
PubMedDate not supplied

Modified Woodward procedure for Sprengel deformity of the shoulder: long-term results.

Sprengel deformity of the shoulder is characterized by elevation and medial rotation of the inferior pole of the scapula. Surgical treatment is recommended in significantly involved patients to improve cosmetic appearance and function of the involved shoulder. We report long-term results of a Woodward procedure modified by excision of the prominent superomedial border of the scapula for correction of this deformity in 15 patients. Preoperatively, the total abduction of the shoulder averaged 115 degrees, and on follow-up the abduction had improved to an average of 150 degrees. In all patients except one, there was marked improvement in appearance as assessed on Cavendish scale. All patients except two had achieved skeletal maturity at the last follow-up. Eighty-six percent of patients expressed satisfaction with operative results. Our data support the concept that correction achieved by a modified Woodward procedure is not altered by growth and is maintained beyond skeletal maturity.

Adolescent↗
PubMed1988

Open scapulothoracic dissociation with intact neurovascular status in a child.

A case of open scapulothoracic dissociation with intact neurovascular status in an 8-year-old girl is reported. Scapulothoracic dissociation is a rare injury. Most cases present with significant soft tissue disruption in the shoulder region secondary to separation of the scapula from the thorax, and involve major vascular and brachial plexus injuries. This case report illustrates that an obvious roentgenographic scapulothoracic dissociation may be seen without any neurovascular deficit in a child. Successful treatment, with anatomical repair of the muscles and stabilization of the scapula, is described.

Amputation, Traumatic↗
PubMed1996

Scapulothoracic dissociation: a devastating injury.

Scapulothoracic dissociation, although rare, causes significant morbidity and mortality by completely disrupting the attachments of the scapula to the axial skeleton with the skin remaining intact. The defining constellation of injuries is subclavian or axillary vascular disruption, lateral displacement of the scapula, separation of the clavicular articulations with or without fracture of the clavicle, and cervical nerve root avulsion or brachial plexus injury. Orthopedic stabilization, vascular repair, and brachial plexus exploration are mandatory. Above elbow amputation, either primarily or within 24 hours, is recommended for the flail extremity.

Accidents, Traffic↗
PubMed1990

Congenital skin fossae about the shoulder.

Congenital fossae, skin pits, or dimples can form about the shoulder. Little has been written about congenital supraspinous fossae or dimples. They are thought to result from the catching of tissues between a sharp bony post and the uterine wall. The skin and structures become compressed and adherent, and when the pressure is released, the surrounding parts remain tied down, forming small pits or dimples. I report on a congenital fossa in the scapular region of an infant who cried each time the arm was abducted. This congenital fossa did communicate with and adhered to the scapula. Excision of the fossa with its surrounding scar tissue about the scapula plus gentle manipulation gave free motion to the shoulder.

Adipose Tissue↗
PubMed2004

The painful scapulothoracic articulation: surgical management.

To clarify the indications and effectiveness of surgical decompression for scapulothoracic bursitis, 16 patients were evaluated, who during a 5-year period, had surgical treatment of refractory pain and snapping in the scapulothoracic region. Twelve women and four men with a mean age of 41 years had one of five methods of surgical decompression of the scapulothoracic articulation. Six patients had an open resection of the scapulothoracic bursa with excision of the superomedial portion of the scapula, two had this procedure using an arthroscopic method, and six had a combined approach with arthroscopic scapulothoracic bursectomy and open resection of the superomedial scapula through a small incision. One patient had an arthroscopic and one an open scapulothoracic bursectomy only. At final followup of an average of 36 months (range, 24-69 months), 81% of patients reported satisfaction with the procedure and indicated they would have it again based on the relief they obtained from pain. The Simple Shoulder Test was 9.8 (range, 2-12). Although there was no statistical difference in the success using any given technique, we thought that the combined open and arthroscopic approach was the most effective, and surgical treatment is an acceptable method for treatment of refractory painful scapulothoracic bursitis.

Adult↗
PubMed2003

Sprengel's deformity: long-term follow-up study of 22 cases.

This study examines the long-term results of 22 patients treated between 1938 and 1974 either surgically or by observation. Fourteen patients (16 scapulas) were treated by observation, seven patients (seven scapulas) were treated surgically by various methods, and one bilateral case was treated conservatively on one side and surgically on the other. The average follow-up was 26 years (range, 10-55) and the average age at follow-up was 32 years (range, 18-67). Shoulder abduction and cosmesis did not change appreciably over the years for the patients that did not undergo surgery, but the surgical patients did demonstrate an average improvement in shoulder abduction of 38 degrees. Seven of eight patients treated surgically reported a subjective improvement in the cosmetic appearance at follow-up, although four patients had an unsightly surgical scar. Pain in the affected shoulder was uncommon at follow-up in either group. We feel that the final result should be assessed from the viewpoint of the functional outcome and cosmetic appearance, independent of the radiographic aspect. Surgical treatment for patients with Sprengel's deformity is indicated when patient and family expectations are either improved cosmesis or improved function.

Adolescent↗
PubMed2005

Complete bilateral agenesis of the ilium in a 7-year-old ambulatory girl: case report.

STUDY DESIGN: A 7-year-old ambulatory girl with complete bilateral agenesis of the ilium is reported. OBJECTIVE: To document the clinical evolution and the spino-pelvic balance of a girl with bilateral agenesis of the ilium. SUMMARY OF BACKGROUND DATA: Scapuloiliac dysostosis is a rare focal skeletal dysplasia consisting in hypoplasia of ilium and scapula. METHODS: A 7-year-old girl with a short stature was referred to our clinic at 35 months of age for an asymptomatic lumbar hyperlordosis. She presented a waddling gait, and normal range of motion of her upper and lower limbs. The neurologic examination was within normal limits. RESULTS: Initial radiographs at 35 months of age showed complete bilateral agenesis of the ilium with preservation of the pubis, ischium, and sacrum, associated with a bilateral high hip dislocation. The lumbar lordosis and sacral slope were 89 degrees and 84 degrees, respectively. A radiographic skeletal survey also showed hypoplasia of both scapulae. At 7 years old, the girl was fully ambulatory, with a waddling gait and had no pain. The sacral slope and lumbar lordosis have increased to 97 degrees and 97 degrees, respectively. There was no evidence of spondylolisthesis. So far, the patient has required no treatment for her condition. CONCLUSION: This article reports a unique case of scapuloiliac dysostosis with complete bilateral agenesis of the ilium in an ambulatory girl. This case indicates that a functional gait is possible with bilateral congenital absence of the ilium, provided that there is adequate muscular support and normal neurologic function.

Child↗
PubMedDate not supplied

Hypoplastic clavicles and lateral scapular redirection.

Three patients with bilateral hypoplastic clavicles and anterolateral displacement of the shoulders and scapulas on the thoracic cage are described. One patient had no family history of the disorder. The mother of the other patient had the same condition, suggesting an autosomal dominant inheritance pattern. In all three patients, the clavicle was underdeveloped and the scapula was redirected onto the lateral rather than the posterior thorax, bringing the entire shoulder forward. None of the patients have any significant functional restriction.

Bone Diseases, Developmental↗
PubMed2004

Elastofibroma dorsi--a case report and review of literature.

Elastofibroma dorsi, named for its characteristic location, is a benign soft tissue tumour occurring most often in the infrascapular region of elderly women. It has been infrequently reported in other anatomic locations. Elastofibroma is a rare non-encapsulated benign tumour characterised by the proliferation of elastin fibres in a stroma of collagenous and fatty connective tissue. This presents as an obvious swelling deep to the scapula, making the scapula prominent, causing periscapular pain, discomfort and loss of range of motion in the shoulder. This article presents a typical case and a brief review of the literature. The clinical aspects and the characteristic magnetic resonance findings are discussed to help emphasise the fact that these tumours are entirely innocuous and need not be subjected to surgical excision.

Aged↗
PubMedDate not supplied

The trapezius osteomusculocutaneous flap in dogs.

A pedicled osteomusculocutaneous flap, composed of the cervical part of the trapezius muscle with its overlying skin and the central spine and body of the scapula, was elevated on the prescapular branch of the superficial cervical vascular pedicle in four dogs. The flap was replaced in an orthotopic location. Bone viability was evaluated using histology, fluorescence bone labeling, and angiography. Bone from the scapular spines had a high percentage of viable osteocytes, positive fluorescence, and vessels were outlined in the angiographic study. Bone from the body of the scapula was not viable based on similar criteria.

Animals↗
PubMed2001

Dynamic measurements of three-dimensional scapular kinematics: a validation study.

The validation of two noninvasive methods for measuring the dynamic three-dimensional kinematics of the human scapula with a magnetic tracking device is presented. One method consists of simply fixing a sensor directly to the acromion and the other consists of mounting a sensor to an adjustable plastic jig that fits over the scapular spine and acromion. The concurrent validity of both methods was assessed separately by comparison with data collected simultaneously from an invasive approach in which pins were drilled directly into the scapula. The differences between bone and skin based measurements represents an estimation of skin motion artifact. The average motion pattern of each surface method was similar to that measured by the invasive technique, especially below 120 degrees of elevation. These results indicate that with careful consideration, both methods may offer reasonably accurate representations of scapular motion that may be used to study shoulder pathologies and help develop computational models.

Adult↗
PubMed1990

Primary bone tumours of the thoracic skeleton: an audit of the Leeds regional bone tumour registry.

An audit of the Leeds regional bone tumour registry found that primary bone tumours of the thoracic skeleton constituted 90 of the 2004 cases (4.5%). Thirty seven per cent occurred in the ribs, 32% in the scapulae, 11% in the thoracic vertebrae, 11% in the sternum, and 9% in the clavicles. Malignant tumours were more common than benign (54 v 36) and occurred in an older population (mean ages 47 and 31 years). The scapula was the most common site for malignant lesions and the ribs the most common site for benign tumours. Chondrosarcoma was the commonest tumour in older patients, fibrous dysplasia and plasmacytoma in the middle age group, and eosinophilic granuloma in children. Presenting symptoms were a poor guide to whether the lesion was malignant or not. This and the small proportion of correct preoperative diagnoses indicate the need for early biopsy. Bone tumour registries provide a valuable source of cumulative information about uncommon tumours and facilitate accurate diagnosis, teaching, and research.

Adolescent↗
PubMed1977

Functionally induced alteration of adult scapular morphology.

The dependence of the growth and development of the scapula on its functional matrix has been clearly defined by a number of experimental studies. Early modifications of this functional matrix may result in an altered scapular morphology [Howell, 1917]. Further, extreme developmental muscular hypofunction results in an increase in scapular breadth and a decrease in length [Riesenfeld, 1966; Doyle, 1976]. However, these studies have been confined to the scapular growth period and no findings have been published on the effect of scapular hypofunction in adults. The present paper addresses this problem. Adult scapular hypofunction in the rat was produced by unilateral amputation of the upper arm. Statistically significant (p less than 0.001) differences in intraindividual scapular breadth dimensions are reported. Further, an increase in the relative instability of the scapular length dimension was observed. No differences in gross scapular morphology resulted from the hypofunctional condition. It is concluded that the functional matrix of the scapula determines a unique morphology during the course of development. Once established, scapular morphology is relatively fixed and only unstable dimensions such as breadth are predictably responsive to a changed matrix.

Animals↗
PubMed1981

Alteration of Scapular morphology through experimental behavioral modification in the laboratory mouse (Mus musculus).

It is demonstrated that the behavior/morphology interface can be studied in controlled experiments. The normal locomotor behavior of the laboratory mouse (Mus musculus) was modified so that animals were restricted to either a plantigrade, 'non-climbing', control environment or an experimental, suspensory, 'climbing' environment. Distinct scapular correlates of the modified behavior were observed. Climbing experimental animals exhibited narrower scapulae with angular measurements consistent with reduced scapular breadth. Plantigrade control animals exhibited broader more squared scapulae. It is suggested that the methodology used here can be extended to natural populations with analogous locomotor behaviors.

Animals↗
PubMed2005

Scapular position and orientation in throwing athletes.

BACKGROUND: Despite the recognized importance of proper 3-dimensional motion of the scapula in throwers, minimal research has quantified scapular position and orientation in throwing athletes. HYPOTHESIS: Throwing athletes exhibit scapular position and orientation differences when compared to nonthrowing control subjects. STUDY DESIGN: Descriptive laboratory study. METHODS: Scapular position and orientation during scapular plane humeral elevation were assessed with electromagnetic tracking in a group of 21 throwing athletes and 21 control subjects. Scapular upward/downward rotation, internal/external rotation, anterior/posterior tipping, elevation/depression, and protraction/retraction were assessed. RESULTS: The throwing athletes demonstrated significantly increased upward rotation, internal rotation, and retraction of the scapula during humeral elevation. No differences in anterior/posterior tipping and elevation/depression were present. CONCLUSIONS: The results indicate that throwing athletes have scapular position and orientation differences compared to non-throwing athletes. This suggests that throwers develop chronic adaptation for more efficient performance of the throwing motion. CLINICAL RELEVANCE: Clinicians evaluate scapular position, orientation, and movement in throwing athletes as part of the evaluation of shoulder injuries associated with the throwing motion. The current study provides clinicians with an understanding of the types of adaptations that may be observed in normal, healthy throwing athletes.

Adaptation, Physiological↗
PubMedDate not supplied

Recurrent anterior shoulder instability.

The purpose of this study was to compare 2 radiographic methods for measuring anteversion and to determine whether glenoid anteversion is a significant factor in recurrence of instability after anterior repair. West Point axillary roentgenograms were obtained in 128 patients (138 shoulders) at a mean of 9 years after surgery. Two methods to measure glenoid anteversion were compared: The angle between the glenoid and the body of the scapula, and the angle between the glenoid and the posterior margin of the acromion. There was less variation in the measurements using the glenoid margin-posterior acromion angle. By this method, anteversion was 11 degrees +/- 4 degrees for the 15 patients with multiple (2 or more) recurrences, 8 degrees +/- 3 degrees for the 15 patients with 1 recurrence, and 6 degrees +/- 5 degrees for the 109 patients with no recurrences. Although these differences are statistically significant (P = 0.003), they probably are not clinically important because they are small (mean of only 5 degrees). The differences obtained by measuring the angle between the glenoid and the body of the scapula were not statistically significant.

Acromion↗
PubMedDate not supplied

The role of the acromioclavicular ligaments and the effect of distal clavicle resection.

To determine the role of the acromioclavicular ligaments in controlling scapular rotation about the distal clavicle and the effects of distal clavicle resection, we used 13 fresh shoulders consisting of the clavicle, acromioclavicular ligaments, coracoclavicular ligaments, and scapula. The range of motion was measured using a specially designed goniometer for each of the three orthogonal axes of rotation of the scapula with reference to the clavicle: anterior-posterior axial rotation, protraction-retraction, and abduction-adduction. We did two experiments involving sequential sectioning. Range of motion was measured in the intact shoulder and after each sectioning cut. The order of sectioning in Experiment 1 (six shoulders) was 1) the inferior acromioclavicular ligament, 2) removal of 5 mm of the distal clavicle, and 3) the superior acromioclavicular ligament. In Experiment 2 (seven shoulders) the order was 1) the superior acromioclavicular ligament, 2) removal of 5 mm of the distal clavicle, and 3) the inferior acromioclavicular ligament. The most important results were 1) only 5 mm of the distal clavicle needs to be resected to ensure that no bone-to-bone contact occurs in rotation postoperatively and 2) there was no difference in the end result (for range of motion in any of the three axes) whether the inferior acromioclavicular ligament or the superior acromioclavicular ligament was cut before removal of 5 mm of the distal clavicle.

Acromioclavicular Joint↗