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At least 127 records · Page 7Linked to original sources
PubMed1991

The bipedicled osteocutaneous scapula flap: a new subscapular system free flap.

Thirty-six adult dissections (14 cadaver and 22 operative) demonstrate the constant presence of the angular branch of the thoracodorsal artery as a vascular pedicle to the inferior pole of the scapula. This vessel originated in all cases just proximal or distal to the serratus branch of the thoracodorsal artery and arborized to the periosteum 6 to 9 cm from the bony branch of the circumflex scapular artery. In eight patients, scapular osteocutaneous flaps were raised preserving the angular branch and the circumflex scapular artery and dissecting up to the subscapular vessels. In all cases, bone was independently perfused by the angular branch. In all six cases where the angular branch was the sole supply to bone, technetium-99m scans demonstrated perfusion. Addition of this vascular pedicle to scapula bone allows two separate bone flaps with one microanastomosis and provides a longer arc of rotation between skin supplied by the circumflex scapular artery and bone. Donor-site morbidity was no greater than with the standard scapula flap.

Adult↗
PubMed1996

The prefabricated combined scapula flap for bony and soft-tissue reconstruction in maxillofacial defects--a new method.

A concept for improving the precision of reconstruction of the maxilla in terms of form and function, including gnathologic, functional, and prosthetic aspects, is presented with a prefabricated combined scapula flap. In four cases, a bony flap from the lateral border of the scapula with osseointegrated titanium implants, covered with skin grafts and encapsulated with a Goretex sheet to create a stable soft-tissue coverage, was performed. Three months later, the prefabricated combined scapula flap was harvested and transferred to reconstruct a maxillary bony and soft-tissue defect in the face using microsurgical vascular anastomoses to the facial vessels. One flap was lost because of vascular thrombosis and was repeated successfully 1 year later. In each of the four cases, full dental rehabilitation and marked improvement of the facial contour was achieved in a single surgical intervention of the face. For this purpose, new radiodiagnostic methods for precise correlation between the maxillofacial defect and the donor area were use. With this new concept, an organ-specific reconstruction of soft-and bony-tissue defects of the alveolar ridge and the hard palate, with a pseudogingiva and teeth, is possible in an optimal way.

Adolescent↗
PubMed2006

Function, ontogeny and canalization of shape variance in the primate scapula.

Primates have shoulders adapted to a wide range of locomotor functions from terrestrial pronograde quadrupedalism to highly arboreal suspensory behaviours. The shape of the scapula tightly follows these functional differences. Previous analyses of primate postcrania, including the scapula, indicate that quadrupedal monkeys are less variable than non-quadrupeds. It was previously suggested that this difference was due to a relationship between the strength of stabilizing selection and the functional demands of the upper limb. Here it is shown that intraspecific scapular shape variance is highly correlated with the degree of committed quadrupedalism. Primates that engage in frequent suspensory behaviours (e.g. apes and ateline monkeys) average twice the amount of shape variance as quadrupeds (e.g. Old World monkeys and Saimiri). Because this difference in intraspecific shape variance is apparent in infants and does not increase or decrease appreciably over ontogeny, it is not likely that differences in postnatal growth, neuromuscular control or environmental factors such as habitat structure/composition are the primary contributors to differences in adult shape variance. Instead variance in embryonic factors that affect the shape/size of the scapula or epigenetic factors associated with muscle attachments are more likely candidates. In particular, the heterogeneous functional demands of the non-quadrupedal shoulder probably reduce the stringency of stabilizing selection, resulting in the persistence into adulthood of increased amounts of embryonically generated scapular shape variance.

Animals↗
PubMed1993

Scapula winging in a sports injury clinic.

Scapula winging is an uncommon condition but one which may be underdiagnosed. Four patients with scapula winging referred to a sports injury clinic are presented. None of the patients was aware of any trauma and a traction injury to the long thoracic nerve is proposed as the aetiology of this condition. These case reports emphasize the importance of excluding winging of the scapula in patients who present to sports injury clinics with shoulder pain.

Adult↗
PubMed2006

Osteochondroma of the scapula associated with winging and large bursa formation.

OBJECTIVE: To report a case of scapular osteochondroma associated with pain and winging that is rarely reported in the medical literature. CASE PRESENTATION AND IDENTIFICATION: A 19-year-old male presented with pain and winging of the right scapula. CT scan revealed an osteochondroma of the medial border of the scapula with a large bursa between the chest wall and the tumour. Excision of the tumour relieved the symptoms. Pathological study showed osteochondroma of the scapula. In a follow-up 1 year later he was free of pain with no clinical or radiological sign of recurrence. CONCLUSION: A case of scapular osteochondroma associated with pain and winging treated by excision and follow-up showed no sign of clinical or radiological recurrence.

Adult↗
PubMed1996

The scapula: principles of construction and stress.

According to current generally accepted theories, analysis of the shape of a bone provides clues to the stresses acting upon it. Although many investigations have ensured that understanding of the lower limb is relatively advance, knowledge relating to the upper limb, and particularly to the scapula, is still far from complete. We have therefore endeavoured to interpret the shape of this bone morphometrically. To this end various scapular parameters have been standardised and statistically analysed, and the results examined both from the functional and the clinical points of view. Our investigation has established that, as in the case of the long bones, the form of the scapula is dependent upon both height and sex. Assessment of the architecture of the subacromial space and its possible parameters of influence have also demonstrated that the size of this space is essentially dependent upon the height of the subject and the size of the acromial and scapulospinal angles. A short distance between the acromion and the upper edge of the glenoid cavity and a small glenoid-spinal angle can be regarded from a functional point of view as factors predisposing to the development of the impingement syndrome. We have also been able to show that certain constant structural features produce an optimal distribution of the forces acting upon the scapula. In particular, the relationship of the supporting pillars (the lateral border and the spine) of this bone to one another appears to represent the expression of an ideal adaptation to the action of those forces.

Humans↗
PubMed1989

Antenatal measurement of scapula length using ultrasound.

In 76 fetuses from 14 weeks of gestation through to term, measurements of the scapula were made using ultrasound. Statistical analysis of the results revealed a highly significant correlation between scapula measurements and gestational age, biparietal diameter, fetal femur length and fetal abdominal circumference (r = 0.93, 0.91, 0.95, and 0.91, respectively). In particular, values related to length of the scapula were highly correlated with femur length. These findings show that this measurement is useful as an adjunct to assessing development as well as growth of the femur and dating parameters of the fetus in utero.

Embryonic and Fetal Development↗
PubMedDate not supplied

Chondromyxoid fibroma of the scapula associated with aneurysmal bone cyst.

A rare case of chondromyxoid fibroma of the scapula in a 21-year-old man is presented. This case is of interest because of its unusual site and association of aneurysmal bone cyst. Although chondromyxoid fibroma is uncommon bone tumor of the scapula, it should be considered in the differential diagnosis of expansile osteolytic lesion of the scapula.

Adult↗
PubMed2002

That darn scapula: a common pitfall in interpreting the chest radiograph.

For the inexperienced interpreter of chest radiographs, the normal scapula can mimic some very common and potentially serious abnormalities. Failure to recognize this normal bony structure can lead to needless diagnostic work up and treatment. The potentially mimicked abnormalities fall into 3 major categories: lung parenchymal abnormalities, pleural abnormalities, and bone abnormalities. This report discusses scapula anatomy as it pertains to chest radiographic anatomy, and the reasons for misinterpretations, and shows examples of the scapula mimicking pathologic processes.

Diagnostic Errors↗
PubMedDate not supplied

[Treatment of scapula alata with a new surgical technique].

By analysing the various surgical procedures used in the management of scapula alata, the author describes a personal technique where scapula is fixed to the 7th rib with the shot palmar tendon. For the stabilisation of the scapula, its inferior angle introduced under the great dorsal is sutured with strong catgut, the needle entering from under the depth of muscle and emerging on its posterior aspect where catgut ends are knotted.

Adult↗
PubMed1986

Computed tomography of the scapula.

Twenty eight patients with bony lesions involving the scapula were investigated by CT. Three different patient positions were tested for optimal visualisation of the scapula. An asymmetric patient positioning is recommended. CT is of value in the management of lesions involving the scapula and in the demonstration of the extent of the tumour within bone and adjacent soft tissue.

Adolescent↗
PubMed1988

Snapping scapula: a review of the literature and presentation of 14 patients.

The syndrome of pain at the vertebral edge of the scapula and snapping associated with movement of the shoulder that occurs spontaneously after trauma or surgical procedures to the shoulder girdle is relatively common. The snapping is described in the literature as being due to an exostosis on the undersurface of the vertebral angle of the scapula, which rides across the rib cage. The pain has been reported to be the result of inflamed bursae located between the scapula and adjacent thorax or over the scapular exostosis. This retrospective study of a small group of patients with the syndrome attempts to define, by detailed x-ray studies, the presence or absence of exostosis at the vertebral angle. In none of these cases was a bony abnormality or exostosis identified clinically or radiologically. The irritating symptoms can be relieved by physiotherapy; surgery is unnecessary.

Adolescent↗
PubMed1985

[Dimensions of the human scapula].

The study of human scapula dimensions is carried out on 110 scapulas of european adults. The statistical analysis of the results concerning the maximum height of the scapula, as well as those of the supraspinous and infraspinous fossa, and also the medial angle, show the absence of statistically significant difference between right and left sides.

Adult↗
PubMed1982

[Evolutionary significance of reciprocal biological effects of form and function using the example of the scapula in higher primates. 1].

The shoulder-blades of 99 catarrhine primates were investigated metrically and morphologically. In order to obtain comparable data, each analysed shoulder-blade was orientated in the same way in a 3-dimensional coordinate system. With the help of a diopthograph, the 3 planes were drawn without distorsion. On these planes the dimensions and angles were measured. These method produced the advantages of taking homologues data as well as of being able to compare the morphological data and its variability. Within the catarrhine primates, the area of the scapula (Fossa infra- and supraspinata) correlates highly significant with the body weight. Regarding the proportions and dimensions of the area of the scapula, there is no difference between the gibbons and the monkeys, regarding the dimensions, proportions and angles of the processes (acromion and coracoid) as well as the vertebral border of the scapula, the gibbons are close to the great apes. The areas of the shoulder-blades of the monkeys, where the shoulder stabilizing muscles originates, are fundamentally equal to each other. Whether body weight nor locomotion have an essential influence on its shape and structure (excl. Mandrillus). On the other hand, the variability of the joint area is considered and the processes are small. The gibbons, the great apes, and men are highly variable regarding the dimensions and the proportions of the area of the shoulder-blades. Regarding the dimensions, proportions, and angles of the acromion and the coracoid, where the shoulder joint stabilizing muscles originate, as well as the vertebral border, there are no fundamental differences between them and the processes are large and robuste.

Animals↗
PubMed1995

Evaluation and treatment of the winged scapula.

Winging of the scapula is often associated with palsy of the serratus anterior muscle, but can be due to numerous pathologic processes. Often representing more than just a cosmetic deformity of the shoulder, it can lead to significant pain and functional impairment. Winging can be due to disease in the nerves, muscles, bones, and joints in the periscapular area and may be either a static or dynamic deformity. Treatment of the winged scapula depends on the severity of the patient's complaints, and the exact treatment required is determined by the underlying pathologic process. A systematic approach to the winged scapula is essential to ascertain the underlying cause and successfully manage this deformity of the shoulder girdle.

Accessory Nerve↗
PubMed2000

The role of the scapula in the rehabilitation of shoulder injuries.

OBJECTIVE: To present a clinical understanding of the role the scapula plays in the mechanics of shoulder function and specialized techniques for the rehabilitation of injuries around the shoulder girdle. BACKGROUND: The scapular musculature is often neglected in the evaluation and treatment of shoulder injuries. This lack of attention often degenerates into the incomplete evaluation and rehabilitation of scapular dysfunction. Dysfunction or weakness of the scapular stabilizers often results in altered biomechanics of the shoulder girdle. The altered biomechanics can result in (1) abnormal stresses to the anterior capsular structures, (2) the increased possibility of rotator cuff compression, and (3) decreased performance. DESCRIPTION: We review the anatomy and role of the scapula, the pathomechanics of injury and dysfunction, and the evaluation and rehabilitation of the scapula. CLINICAL ADVANTAGE: Knowledge of how the scapular muscles influence function at the shoulder builds a strong foundation for the clinician to develop rehabilitation programs for the shoulder.

Journal Article↗
PubMed1986

[The 2 key muscles in thoracotomy for excision of the lung. The latissimus dorsi and the levator scapulae muscles].

Anatomical data related to the thoracotomies performed most frequently in lung surgery are described in some detail: continuity between serratus anterior and levator scapulae as a vide muscular sheet possessing a common deep aponeurosis (thoracolumbar fascia) extending Gilis' space to the vertebral column as the levator scapulae-thoraci space; presence of a "composite aponeurosis" in the posterior angle between serratus anterior and levator scapulae, covering the 8th rib triangle or triangle of auscultation; long costal insertion area and presence of two differently orientated muscle layers for the digitations, particularly of apical bundle. Supplied by a rich vascularization of multiple sources, the serratus anterior and latissimus dorsi are two muscles with single longitudinal nerve pedicles derived from brachial plexus. It is certainly the denervation which is responsible for the distal atrophy of these muscles "sectioned on the right of the selected ribs" following conventional thoracotomy. To avoid esthetic and functional sequelae this innervation must be preserved as far as possible by: interrupting division of serratus anterior anterior to long thoracic nerve and avoiding inclusion of axillary border of latissimus dorsi during lateral thoracotomy; sectioning the latissimus dorsi as low as possible--the other muscles being simply freed and inclined--during lateral thoracotomy.

Arteries↗
PubMed2007

Correlation between the four types of acromion and the existence of enthesophytes: a study on 423 dried scapulas and review of the literature.

The purpose of this study was to correlate the four types of acromial shape with the existence of enthesophytes, which together comprise two important parameters for subacromial impingement syndrome and rotator cuff tears. In addition, a review of the literature was carried out. Four hundred twenty-three dried scapulas were studied at the Department of Anatomy in the University of Cologne, Germany. Four types of acromion were found: the three classical ones as described by Bigliani et al. ([1986] Orthop Trans 10:216) and a fourth one, where the middle third of the undersurface of acromion was convex (Gagey et al. [1993] Surg Radiol Anat 15:63-70). The correlation between the four types of acromion and the presence of enthesophytes at its anterior undersurface was also recorded. The distribution of acromial types was as follows: type I, flat, 51 (12.1%); type II, curved, 239 (56.5%); type III, hooked, 122 (28.8%); and type IV, convex, 11 (2.6%). Enthesophytes were found in 1 of type I (2%), in 19 of type II (7.9%), in 46 of type III (37.7%), and in 0 (0%) of type IV acromions. Overall, 66 (15.6%) out of 423 scapulas had enthesophytes. In all cases, they were localized at the site of the coracoacromial ligament insertion on the acromion. Enthesophytes were significantly (P < 0.05) more common in type III acromions and this combination is particularly associated with subacromial impingement syndrome and rotator cuff tears. In type I and in type IV acromions, the incidence of enthesophytes is very small and, according to other studies, with these two acromial types rotator cuff tears are also rare.

Acromion↗