BACKGROUND Scapular fracture has a low incidence rate, accounting for 0.4%-0.9% of allfractures, and scapular neck fractures are extremely rare, comprisingapproximately 7%-25% of all scapular fractures. Scapular neck ...BACKGROUND Scapular fracture has a low incidence rate, accounting for 0.4%-0.9% of allfractures, and scapular neck fractures are extremely rare, comprisingapproximately 7%-25% of all scapular fractures. Scapular neck fractures are oftenstudied as case reports mostly accompanied by other injuries, thus leading toconfusion. All previous cases of scapular neck fractures are not associated withrotator cuff injuries.CASE SUMMARY A 62-year-old man was admitted to our emergency department 6 h after his rightshoulder and back were impacted by heavy objects. The patient presented chesttightness and shortness of breath. Chest computed tomography (CT) showedpneumohemothorax, multiple rib fractures, and right scapula fractures. ThreedimensionalCT reconstruction of the right shoulder joint showed a trans-spinousscapular neck fracture with a glenohumeral joint dislocation. Rotator cuff injurywas suspected because the patient had a glenohumeral joint dislocation and wasthen confirmed by shoulder magnetic resonance imaging. A staged surgery wasperformed, including open reduction and internal fixation of the right scapulafracture and repairing of rotator cuff by right shoulder arthroscopy. At the 5-mofollow-up, the fracture line was blurred and the shoulder joint function was good.CONCLUSION Fracture of the scapular neck combined with rotator cuff tear is rare and therotator cuff injury should not be ignored in clinical work. Stable internal fixationcombined with secondary arthroscopic repair of rotator cuff tear can achieve goodresults.展开更多
Neck pain is common and has multiple sources, but correct diagnosis and matched treatment provide the best outcomes. The first description of ultrasound-guided dorsal scapular nerve blockade using a single-shot local ...Neck pain is common and has multiple sources, but correct diagnosis and matched treatment provide the best outcomes. The first description of ultrasound-guided dorsal scapular nerve blockade using a single-shot local anesthetic technique for the diagnosis and treatment of neck pain is reported. A 38-year-old female patient presented with neck pain, and the history and clinical examination strongly suggested myofascial pain affecting the middle scalene muscle. The pain had been unresponsive to pharmacological therapy or physiotherapy. After identifying the dorsal scapular nerve (DSN) in the body of the middle scalene muscle, an ultrasound-guided nerve block was performed using a single injection of local anesthetic to alleviate the patient’s pain. It has been demonstrated that the dorsal scapular nerve can be identified in the neck and effectively blocked using ultrasound guidance. This technique has the potential to assist in the diagnosis and treatment of neck pain originating from the middle scalene muscle.展开更多
文摘BACKGROUND Scapular fracture has a low incidence rate, accounting for 0.4%-0.9% of allfractures, and scapular neck fractures are extremely rare, comprisingapproximately 7%-25% of all scapular fractures. Scapular neck fractures are oftenstudied as case reports mostly accompanied by other injuries, thus leading toconfusion. All previous cases of scapular neck fractures are not associated withrotator cuff injuries.CASE SUMMARY A 62-year-old man was admitted to our emergency department 6 h after his rightshoulder and back were impacted by heavy objects. The patient presented chesttightness and shortness of breath. Chest computed tomography (CT) showedpneumohemothorax, multiple rib fractures, and right scapula fractures. ThreedimensionalCT reconstruction of the right shoulder joint showed a trans-spinousscapular neck fracture with a glenohumeral joint dislocation. Rotator cuff injurywas suspected because the patient had a glenohumeral joint dislocation and wasthen confirmed by shoulder magnetic resonance imaging. A staged surgery wasperformed, including open reduction and internal fixation of the right scapulafracture and repairing of rotator cuff by right shoulder arthroscopy. At the 5-mofollow-up, the fracture line was blurred and the shoulder joint function was good.CONCLUSION Fracture of the scapular neck combined with rotator cuff tear is rare and therotator cuff injury should not be ignored in clinical work. Stable internal fixationcombined with secondary arthroscopic repair of rotator cuff tear can achieve goodresults.
文摘Neck pain is common and has multiple sources, but correct diagnosis and matched treatment provide the best outcomes. The first description of ultrasound-guided dorsal scapular nerve blockade using a single-shot local anesthetic technique for the diagnosis and treatment of neck pain is reported. A 38-year-old female patient presented with neck pain, and the history and clinical examination strongly suggested myofascial pain affecting the middle scalene muscle. The pain had been unresponsive to pharmacological therapy or physiotherapy. After identifying the dorsal scapular nerve (DSN) in the body of the middle scalene muscle, an ultrasound-guided nerve block was performed using a single injection of local anesthetic to alleviate the patient’s pain. It has been demonstrated that the dorsal scapular nerve can be identified in the neck and effectively blocked using ultrasound guidance. This technique has the potential to assist in the diagnosis and treatment of neck pain originating from the middle scalene muscle.
