Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-yea...Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.展开更多
Purpose: The approach to resect subscapular and subrhomboid tumors needs elevation of the scapula. This is usually performed by detaching the muscles from the margo medialis of the scapula. We wish to communicate our ...Purpose: The approach to resect subscapular and subrhomboid tumors needs elevation of the scapula. This is usually performed by detaching the muscles from the margo medialis of the scapula. We wish to communicate our technique of a longitudinal osteotomy of the margo medialis for improved refixation of the muscles. Patients and Methods: 5 patients with subscapular and one patient with a subrhomboid benign tumor were operated on using this technique. Results: All patients achieved stable healing and full functional recovery;only in one patient there was slightly reduced elevation of the arm. Conclusion: Elevation of the muscles inserting into the medial scapular margo with a small rim of bone facilitates refixation and allows for excellent restitution of function.展开更多
AIM: To develop a better understanding of scapulohumeral rhythm during scapular plane shoulder elevation.METHODS: Thirteen healthy, college-aged subjects participated in this study. Subjects were free from any upper e...AIM: To develop a better understanding of scapulohumeral rhythm during scapular plane shoulder elevation.METHODS: Thirteen healthy, college-aged subjects participated in this study. Subjects were free from any upper extremity, neck or back pathology. A modified digital inclinometer was utilized to measure scapular upward rotation of the subject's dominant shoulder. Upward rotation was measured statically as subjects performed clinically relevant amounts of shoulder elevation in the scapular plane. Testing order was randomized by arm position. Scapular upward rotation was assessed over the entire arc of motion and over a series of increments. The percent contributions to shoulder elevation for the scapula and glenohumeral joint were calculated. Scapulohumeral rhythm was assessed and represented the ratio of glenohumeral motion to scapulothoracic motion(glenohumeral elevation: scapular upward rotation). A one-way ANOVA wasused to compare scapular upward rotation between elevation increments.RESULTS: Scapulohumeral rhythm for the entire arc of shoulder elevation was equal to a ratio of 2.34 :1 and ranged from 40.01:1 to 0.90:1 when assessed across the different increments of humeral elevation. Total scapular motion increased over the arc of shoulder elevation. The scapula contributed 2.53% of total motion for the first 30 degrees of shoulder elevation, between 20.87% and 37.53% for 30o-90 o of shoulder elevation, and 52.73% for 90o-120 o of shoulder elevation. Statistically significant differences in scapular upward rotation were identified across the shoulder elevation increments [F(3,48) = 12.63, P = 0.0001].CONCLUSION: Clinically, we must recognize the usefulness of the inclinometer in documenting the variable nature of scapulohumeral rhythm in healthy and injured shoulders.展开更多
Bone tumors are infrequent within the scapula. Total scapulectomy with massive allograft reconstruction represents an attractive alternative to amputation when the whole scapula is invaded with tumor and the neurovasc...Bone tumors are infrequent within the scapula. Total scapulectomy with massive allograft reconstruction represents an attractive alternative to amputation when the whole scapula is invaded with tumor and the neurovascular bundle can be preserved during tumor resection. We report a case of resection of the scapula and proximal humerus for recurrent osteosarcoma with massive allograft reconstruction of the scapula and proximal humerus. A 22-year-old male patient was seen in February 1992 for a pathological fracture of the proximal left humerus. In July 1992, a resection of the proximal end of the humerus followed by a reconstruction with osteochondral allograft and nail osteosynthesis was performed. The postoperative course was uneventful. In September 2009, 17 years later, the patient presented with a huge tumor developed at the level of the scapula. There was no vascular or neurological symptom. Plain radiography showed an expansive osteolytic mass. CT scan demonstrated scapular and proximal humerus invasion. An extended assessment revealed the presence of two pulmonary nodules. The biopsy confirmed the recurrence of osteosarcoma. The indication of a resection of both the left scapula and the 1992 allograft which was completely invaded at its proximal portion and the complete reconstruction of the scapula and the proximal humerus with allograft was made. One year postoperatively, we note a favourable outcome in terms of musculoskeletal functions. Despite two resection surgeries of pulmonary nodules and chemotherapy treatments, the patient developed new lung metastases and an unfavourable outcome. Although shoulder function was almost completely eliminated following surgery, preservation of elbow, wrist and finger motion resulted in an acceptable level of postoperative limb function. This reconstruction appears to be an attractive technique to be used in similar cases. The necessity of a reliable tissue bank with quality allografts in sufficient number is paramount.展开更多
Alveolar soft-part sarcoma (ASPS) is an uncommon, aggressive soft-tissue neoplasm, occurring in less than 1% of sarcomas. It is typically found in the head and neck tissues in children or in the deep soft tissues of t...Alveolar soft-part sarcoma (ASPS) is an uncommon, aggressive soft-tissue neoplasm, occurring in less than 1% of sarcomas. It is typically found in the head and neck tissues in children or in the deep soft tissues of the lower extremities in young adults. This tumor arises primarily within the skeletal muscles or musculofascial planes. Primary involvement of bone is extremely rare. ASPS has poor prognosis with a propensity for recurrence as well as distant metastasis. In this report, we present a 25-year-old male with primary ASPS in the left scapular bone and discuss the histopathological and immunohistochemical features of this sarcoma.展开更多
The scapula (shoulder blade) is a large triangular-shaped bone located in the upper back and includes two muscles on each side. The scapula is surrounded and supported by a complex system of muscles that work together...The scapula (shoulder blade) is a large triangular-shaped bone located in the upper back and includes two muscles on each side. The scapula is surrounded and supported by a complex system of muscles that work together to help in the arm movement. If some condition or injury causes these muscles to become imbalanced or weak, the position of the scapula can be altered at rest or in motion. A change in the scapular positioning or motion can make difficulties in the arm movement, especially when performing overhead activities and may cause shoulder weakness. Acupuncture treatment as part of the Traditional Chinese Medicine is most commonly used treatment for treating musculoskeletal disorders. In the treatment of scapular muscle fasciitis the fire-needle acupuncture gave the fastest and best results in our practice. The aim of the treatment is to break up the scar tissue and the adhesions which commonly form at the site, to relax the levator scapula muscle and restore local normal blood and energy flow. In the research are included 13 patients, 6 male and 7 female, on age from 24 to 70. All patients had scapular pain and on all was performed fire-needle acupuncture. Most common age groups are 50 - 60, most patients have pain on the right scapula and most of them—9 have done only one treatment. A long-term problem with the scapula muscle can be resolved with only one fire-needle acupuncture treatment.展开更多
Snapping scapula is an uncommon condition described as palpable, audible, or painful crepitus of the scapula that causes diminished quality of life.l Until now it is still a largely under-recognized problem because of...Snapping scapula is an uncommon condition described as palpable, audible, or painful crepitus of the scapula that causes diminished quality of life.l Until now it is still a largely under-recognized problem because of its diverse causes. The etiology of the problem is mainly divided into three major categories: bursitis, muscle abnormality, and bony or soft-tissue abnormality.展开更多
Background:Scapular bronchogenic cyst(SBC)is rare.Methods:A sinus on a boy's left scapula was excised.Results:Histopathological analysis showed the epithelium with scattered PAS-positive goblet cells was positive ...Background:Scapular bronchogenic cyst(SBC)is rare.Methods:A sinus on a boy's left scapula was excised.Results:Histopathological analysis showed the epithelium with scattered PAS-positive goblet cells was positive for CEA and CK7.Conclusion:SBC should be suspected of a superfi cial scapular skin lesion in children.展开更多
This article presents a fossil human scapula which was found in situ from the lower part of the Salawusu Formation in 1980 at the Salawusu site of Inner Mongolia,China. The stratum is dated from 70.9±6.2 ka BP to...This article presents a fossil human scapula which was found in situ from the lower part of the Salawusu Formation in 1980 at the Salawusu site of Inner Mongolia,China. The stratum is dated from 70.9±6.2 ka BP to 124.9±15.8 ka BP by TL method. Dates from 44±7 ka BP to 63±3 ka BP, 61―68 ka BP and 35.34±2 ka BP are obtained for the lower part of this layer by 230Th, IRSL and 14C respectively. Based on the comparisons between this scapula and the scapulae of Neanderthals, Skhul/Qafzeh fossils, Eurasian Upper Paleolithic specimens and recent modern humans on the glenoid fossa, axillo-spinal angle, axillary border and other features, the present authors arrived at a preliminary conclusion that this Salawusu scapula is characterized by modern fea- tures of Upper Pleistocene humans mixed with a Neanderthal-like feature.展开更多
目的:探讨腋后路治疗IdebergⅠa及Ⅱ型肩胛盂骨折的疗效。方法:回顾性分析2018年12月至2021年9月采用腋后路治疗的9例肩胛盂下部分骨折患者的资料,男3例,女6例;年龄50~78岁。所有患者骨折为闭合性骨折,依据肩胛盂骨折Ideberg分型:Ⅰa型6...目的:探讨腋后路治疗IdebergⅠa及Ⅱ型肩胛盂骨折的疗效。方法:回顾性分析2018年12月至2021年9月采用腋后路治疗的9例肩胛盂下部分骨折患者的资料,男3例,女6例;年龄50~78岁。所有患者骨折为闭合性骨折,依据肩胛盂骨折Ideberg分型:Ⅰa型6例,Ⅱ型3例。分别于术后第6、12周及6、12个月摄肩关节正、侧位X线片,记录所有患者末次随访时的Constant-Murley肩关节评分,上肢功能障碍(disability of the arm,shoulder and hand,DASH)评分,骨折愈合情况以及其他并发症情况。结果:术后9例患者获得随访,时间6~15个月。末次随访时9例均获得骨性愈合,愈合时间3~6个月,末次随访时患者的Constant-Murley评分为55~96分;DASH评分为3.33~33.33分。结论:腋后路内固定治疗IdebergⅠa、Ⅱ型肩胛盂骨折有效解决了前方入路显露肩胛盂下部分骨折困难的问题,可避免肩胛下肌以及关节囊医源性损伤,临床效果满意,值得临床推广使用。展开更多
文摘Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.
文摘Purpose: The approach to resect subscapular and subrhomboid tumors needs elevation of the scapula. This is usually performed by detaching the muscles from the margo medialis of the scapula. We wish to communicate our technique of a longitudinal osteotomy of the margo medialis for improved refixation of the muscles. Patients and Methods: 5 patients with subscapular and one patient with a subrhomboid benign tumor were operated on using this technique. Results: All patients achieved stable healing and full functional recovery;only in one patient there was slightly reduced elevation of the arm. Conclusion: Elevation of the muscles inserting into the medial scapular margo with a small rim of bone facilitates refixation and allows for excellent restitution of function.
基金Supported by Pennsylvania Athletic Trainers’ Society Research Grant,No.G0900028
文摘AIM: To develop a better understanding of scapulohumeral rhythm during scapular plane shoulder elevation.METHODS: Thirteen healthy, college-aged subjects participated in this study. Subjects were free from any upper extremity, neck or back pathology. A modified digital inclinometer was utilized to measure scapular upward rotation of the subject's dominant shoulder. Upward rotation was measured statically as subjects performed clinically relevant amounts of shoulder elevation in the scapular plane. Testing order was randomized by arm position. Scapular upward rotation was assessed over the entire arc of motion and over a series of increments. The percent contributions to shoulder elevation for the scapula and glenohumeral joint were calculated. Scapulohumeral rhythm was assessed and represented the ratio of glenohumeral motion to scapulothoracic motion(glenohumeral elevation: scapular upward rotation). A one-way ANOVA wasused to compare scapular upward rotation between elevation increments.RESULTS: Scapulohumeral rhythm for the entire arc of shoulder elevation was equal to a ratio of 2.34 :1 and ranged from 40.01:1 to 0.90:1 when assessed across the different increments of humeral elevation. Total scapular motion increased over the arc of shoulder elevation. The scapula contributed 2.53% of total motion for the first 30 degrees of shoulder elevation, between 20.87% and 37.53% for 30o-90 o of shoulder elevation, and 52.73% for 90o-120 o of shoulder elevation. Statistically significant differences in scapular upward rotation were identified across the shoulder elevation increments [F(3,48) = 12.63, P = 0.0001].CONCLUSION: Clinically, we must recognize the usefulness of the inclinometer in documenting the variable nature of scapulohumeral rhythm in healthy and injured shoulders.
文摘Bone tumors are infrequent within the scapula. Total scapulectomy with massive allograft reconstruction represents an attractive alternative to amputation when the whole scapula is invaded with tumor and the neurovascular bundle can be preserved during tumor resection. We report a case of resection of the scapula and proximal humerus for recurrent osteosarcoma with massive allograft reconstruction of the scapula and proximal humerus. A 22-year-old male patient was seen in February 1992 for a pathological fracture of the proximal left humerus. In July 1992, a resection of the proximal end of the humerus followed by a reconstruction with osteochondral allograft and nail osteosynthesis was performed. The postoperative course was uneventful. In September 2009, 17 years later, the patient presented with a huge tumor developed at the level of the scapula. There was no vascular or neurological symptom. Plain radiography showed an expansive osteolytic mass. CT scan demonstrated scapular and proximal humerus invasion. An extended assessment revealed the presence of two pulmonary nodules. The biopsy confirmed the recurrence of osteosarcoma. The indication of a resection of both the left scapula and the 1992 allograft which was completely invaded at its proximal portion and the complete reconstruction of the scapula and the proximal humerus with allograft was made. One year postoperatively, we note a favourable outcome in terms of musculoskeletal functions. Despite two resection surgeries of pulmonary nodules and chemotherapy treatments, the patient developed new lung metastases and an unfavourable outcome. Although shoulder function was almost completely eliminated following surgery, preservation of elbow, wrist and finger motion resulted in an acceptable level of postoperative limb function. This reconstruction appears to be an attractive technique to be used in similar cases. The necessity of a reliable tissue bank with quality allografts in sufficient number is paramount.
文摘Alveolar soft-part sarcoma (ASPS) is an uncommon, aggressive soft-tissue neoplasm, occurring in less than 1% of sarcomas. It is typically found in the head and neck tissues in children or in the deep soft tissues of the lower extremities in young adults. This tumor arises primarily within the skeletal muscles or musculofascial planes. Primary involvement of bone is extremely rare. ASPS has poor prognosis with a propensity for recurrence as well as distant metastasis. In this report, we present a 25-year-old male with primary ASPS in the left scapular bone and discuss the histopathological and immunohistochemical features of this sarcoma.
文摘The scapula (shoulder blade) is a large triangular-shaped bone located in the upper back and includes two muscles on each side. The scapula is surrounded and supported by a complex system of muscles that work together to help in the arm movement. If some condition or injury causes these muscles to become imbalanced or weak, the position of the scapula can be altered at rest or in motion. A change in the scapular positioning or motion can make difficulties in the arm movement, especially when performing overhead activities and may cause shoulder weakness. Acupuncture treatment as part of the Traditional Chinese Medicine is most commonly used treatment for treating musculoskeletal disorders. In the treatment of scapular muscle fasciitis the fire-needle acupuncture gave the fastest and best results in our practice. The aim of the treatment is to break up the scar tissue and the adhesions which commonly form at the site, to relax the levator scapula muscle and restore local normal blood and energy flow. In the research are included 13 patients, 6 male and 7 female, on age from 24 to 70. All patients had scapular pain and on all was performed fire-needle acupuncture. Most common age groups are 50 - 60, most patients have pain on the right scapula and most of them—9 have done only one treatment. A long-term problem with the scapula muscle can be resolved with only one fire-needle acupuncture treatment.
文摘Snapping scapula is an uncommon condition described as palpable, audible, or painful crepitus of the scapula that causes diminished quality of life.l Until now it is still a largely under-recognized problem because of its diverse causes. The etiology of the problem is mainly divided into three major categories: bursitis, muscle abnormality, and bony or soft-tissue abnormality.
基金supported by grants from National Natural Science Foundation of China(No.81300347)Natural Science Foundation of Jiangxi Province of China(No.20132BAB205037).
文摘Background:Scapular bronchogenic cyst(SBC)is rare.Methods:A sinus on a boy's left scapula was excised.Results:Histopathological analysis showed the epithelium with scattered PAS-positive goblet cells was positive for CEA and CK7.Conclusion:SBC should be suspected of a superfi cial scapular skin lesion in children.
基金This work was supported by President Fund of Chinese Academy of Sciences (No. 978) the National Natural Science Foundation of China (Grant Nos. J0530189, 40372015) and the Wenner-Gren Foundation.
文摘This article presents a fossil human scapula which was found in situ from the lower part of the Salawusu Formation in 1980 at the Salawusu site of Inner Mongolia,China. The stratum is dated from 70.9±6.2 ka BP to 124.9±15.8 ka BP by TL method. Dates from 44±7 ka BP to 63±3 ka BP, 61―68 ka BP and 35.34±2 ka BP are obtained for the lower part of this layer by 230Th, IRSL and 14C respectively. Based on the comparisons between this scapula and the scapulae of Neanderthals, Skhul/Qafzeh fossils, Eurasian Upper Paleolithic specimens and recent modern humans on the glenoid fossa, axillo-spinal angle, axillary border and other features, the present authors arrived at a preliminary conclusion that this Salawusu scapula is characterized by modern fea- tures of Upper Pleistocene humans mixed with a Neanderthal-like feature.
文摘目的:探讨腋后路治疗IdebergⅠa及Ⅱ型肩胛盂骨折的疗效。方法:回顾性分析2018年12月至2021年9月采用腋后路治疗的9例肩胛盂下部分骨折患者的资料,男3例,女6例;年龄50~78岁。所有患者骨折为闭合性骨折,依据肩胛盂骨折Ideberg分型:Ⅰa型6例,Ⅱ型3例。分别于术后第6、12周及6、12个月摄肩关节正、侧位X线片,记录所有患者末次随访时的Constant-Murley肩关节评分,上肢功能障碍(disability of the arm,shoulder and hand,DASH)评分,骨折愈合情况以及其他并发症情况。结果:术后9例患者获得随访,时间6~15个月。末次随访时9例均获得骨性愈合,愈合时间3~6个月,末次随访时患者的Constant-Murley评分为55~96分;DASH评分为3.33~33.33分。结论:腋后路内固定治疗IdebergⅠa、Ⅱ型肩胛盂骨折有效解决了前方入路显露肩胛盂下部分骨折困难的问题,可避免肩胛下肌以及关节囊医源性损伤,临床效果满意,值得临床推广使用。