Medial scapular winging following trauma—a case report

Speigner, B.; Verborgt, Olivier; Declercq, G; Jansen, E.J.

doi:10.3109/17453674.2015.1117370

Cited by 14 publications

(27 citation statements)

References 6 publications

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“…In radiography, a precise lateral view of the scapula is needed to reveal the fractured fragment, as it is difficult to identify on anteroposterior view due to overlapping with the ribcage. ISA fracture was overlooked at the time of injury in two of 12 previously reported cases in which the clinical histories were appropriately described [20, 21]. In our case, the fracture was overlooked at the previous clinic the patient visited (Table 2).…”

Section: Discussionmentioning

confidence: 61%

“…Hence, definitive diagnosis of avulsion fracture is often difficult or questionable. In the seven previously reported cases of ISA fracture in which the details at the time of the injury were clearly described, two cases had experienced an impact to the ISA [19, 20] and one chronic case had the scar of a contused wound on the ISA [21]. A direct impact was denied in the other four cases [8, 15, 22, 23], of which two cases had bone insufficiency: one was an insufficiency type stress fracture related to coughing [22] and the other was properly classified as an insufficiency fracture caused by convulsion [23].…”

Section: Discussionmentioning

confidence: 99%

“…The general symptoms in the subacute and chronic phase are an inability to elevate the arm above shoulder level, weakness of arm elevation, and periscapular pain with arm elevation [16, 17, 19–21, 26]. However, a full active range of motion was maintained in two previously reported cases [8, 20] (Table 2). Confirmation of the diagnosis of ISA fracture requires demonstration of the fractured fragment on imaging.…”

Section: Discussionmentioning

confidence: 99%

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Overlooked Fracture of the Inferior Scapular Angle Treated Conservatively

Ogawa

Inokuchi

Honma

2019

Case Reports in Orthopedics

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Isolated fracture of the inferior scapular angle is extremely rare. We present the case of a 20-year-old female with persistent periscapular pain and a winged scapula caused by delayed union of an inferior scapular angle (ISA) fracture. Ten months previously, the patient had a car accident while seated in the left rear passenger seat. The patient visited an orthopedic clinic where a surgeon diagnosed left shoulder contusion without any abnormal radiographic findings. The left arm was kept in a sling for 2 months, as left arm elevation caused severe pain in the upper back. After sling removal, the dull pain around the left scapula continued. The patient presented at our clinic because her mother had noticed the deformity of her back. Radiographs showed a small bony fragment in the ventral side of the ISA. Computed tomography revealed a narrow gap between the ISA and the fragment. The patient's symptoms resolved with conservative treatment that consisted of relative rest for 2 months and subsequent reinforcement exercises of the serratus anterior for 2 months.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Overlooked Fracture of the Inferior Scapular Angle Treated Conservatively

Ogawa

Inokuchi

Honma

2019

Case Reports in Orthopedics

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“…Of the 467 studies assessed by title and abstract, 16 papers [3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] were extracted and their full text was screened. One case report [22] was further excluded at this stage as it did not provide relevant data, such as MOI, management, or outcomes.…”

Section: Resultsmentioning

confidence: 99%

Characteristics, Management, and Outcomes of Inferior Scapula Angle Fractures: A Systematic Review of the Literature

Mousafeiris¹,

Kalyva²,

Rigopoulos³

et al. 2022

Cureus

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Fractures of the inferior angle of the scapula represent a rare entity, with few cases published in the literature to date. Their optimal management is still unclear. A systematic literature search was conducted in PubMed and Google Scholar of reports published between 1977 and 2022. Inclusion criteria were cases presenting inferior scapula angle fractures (ISAF) and reporting management and outcomes. Extracted data included patient demographics (age, sex), mechanism of injury, associated injuries, management, procedures performed, and outcomes. Seventeen studies (22 cases; 19 males and three females) were included. The mean age was 33 years (15 adult and seven pediatric cases). High energy injuries were the most common mechanism of injury (77%). Displacement of the fragment was reported in 64%. The most common initial treatment was conservative (77%); of these cases, more than half failed initial treatment (53%). Of the displaced ISAF cases, 89% failed conservative treatment, contrary to 83% of the nondisplaced cases that were successfully treated conservatively. Surgery yielded 100% success both as initial treatment and after failed conservative management. Displaced fractures should be approached surgically, while conservative management should be reserved for nondisplaced fractures.

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“…There are multiple causes for scapular winging, including iatrogenic, idiopathic and traumatic injuries. While injury of the long thoracic nerve resulting in paralysis of the serratus anterior is the most common traumatic cause, 10 direct traumatic injury to the insertion of the serratus anterior or scapular fractures have also been described to cause scapular winging. 11 If neurological deficits are found, further work-up is necessary to determine the cause and possible treatment of it.…”

Section: Discussionmentioning

confidence: 99%

Traumatic costovertebral joint dislocation

2020

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Rib fractures due to blunt trauma are a common chest injury seen at the emergency department; however, injuries to the costovertebral joints are very rare. We present a case of a 24-year-old man who was admitted after a high-speed car collision and was assessed in a level 1 trauma centre in Amsterdam. He had multiple injuries, including dislocation of the costovertebral joint of ribs 7–10. After performing a literature search we concluded that patients with traumatic costovertebral joint dislocations have a high incidence of vertebral fractures, neurological deficits and additional fractures. We believe that isolated dislocation of one or multiple costovertebral joint(s) can safely be treated conservatively. Close monitoring of the patients is advisable as these injuries are caused by high impact and are associated with other injuries.

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Medial scapular winging following trauma—a case report

Cited by 14 publications

References 6 publications

Overlooked Fracture of the Inferior Scapular Angle Treated Conservatively

Overlooked Fracture of the Inferior Scapular Angle Treated Conservatively

Characteristics, Management, and Outcomes of Inferior Scapula Angle Fractures: A Systematic Review of the Literature

Traumatic costovertebral joint dislocation

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