Scapulothoracic fusion for low-energy intrathoracic scapula dislocation: a report of two cases

Endrizzi, Donald P.; Shubert, Daniel; White, Raymond R.

doi:10.1016/j.jse.2014.12.004

Cited by 3 publications

(12 citation statements)

References 15 publications

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“…Scapular prolapse is a rare complication of thoracotomy with complex causes, which are still not clearly understood, and few cases have been reported. [6,7] Previous studies showed that patients with chest wall defects are prone to have scapular prolapse, [8] but shoulder deformities, shoulder weakness, abnormal movement, chemoradiotherapy, steroids, and muscle relaxant are also considered as possible causes of scapular prolapse. [9][10][11] We suspected that the enlarged intercostal space caused by the removal of some ribs was the main cause of scapular prolapse for this patient, and the removal of the serratus anterior, trapezius, rhomboid space, latissimus dorsi, and other chest wall muscles during the operation was also one of the causes of the prolapse since the loss of the chest wall muscles may affect the location, stability, and movement of the scapula.…”

Section: Discussionmentioning

confidence: 99%

Scapular dislocation following radical surgical excision of lung sarcomatoid carcinoma: A rare case report

Wu,

Qiao,

Liu

et al. 2024

Medicine

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Rationale: Scapular prolapse is a rare complication of thoracotomy. Only a few cases of scapular prolapse after thoracotomy have been reported. Here, we report the case of a 52-year-old male patient who underwent standard posterior thoracotomy for lung sarcomatoid carcinoma invading the left upper chest wall. Patient concerns: The surgery was performed to remove some ribs and chest wall muscles; however, no reconstruction or repair of the chest wall defect was performed. The patient experienced a sharp pain and severe limitation of movement of the left shoulder within 1 month of receiving adjuvant therapy. Diagnoses: The patient was diagnosed with left intrathoracic scapular prolapse after careful consideration of medical history, physical examination, and chest radiography. Interventions: We performed closed manual reduction because the patient refused to undergo surgery. Outcomes: The patient’s shoulder pain and movement limitation were significantly relieved, but the symptoms relapsed. After repeated closed manual reduction, the patient was instructed not to abduct the shoulder joint above 90°. The patient did not relapse during a 1-year observation period. Conclusion: If scapular prolapse occurs, manual or surgical reduction can be selected based on the needs. If a patient refuses to undergo surgery, manual reduction can be an effective treatment method.

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Section: Discussionmentioning

confidence: 99%

Scapular dislocation following radical surgical excision of lung sarcomatoid carcinoma: A rare case report

Wu,

Qiao,

Liu

et al. 2024

Medicine

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“…Five of these patients recovered with conservative treatment, but 2 cases were treated with scapulothoracic arthrodesis [1–4]. …”

Section: Discussionmentioning

confidence: 99%

Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection

Kimura

Sasanuma

Ajiki

et al. 2017

Case Reports in Orthopedics

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We report a case of recurrent locking of the scapula in the thorax after combined lobectomy and thoracic wall resection for advanced lung cancer. The patient was a 52-year-old man with advanced spindle cell carcinoma in his right lung. He had undergone right lung lobectomy and thoracic wall excision (Th1–5). Intrathoracic repair had not been performed to address the defect in the thoracic wall. Two months after the operation he experienced sudden acute pain in the right shoulder. Three-dimensional computed tomography revealed locking of the scapula intrathoracically. The diagnosis was recurrent locking of the scapula in the thorax. He underwent conservative treatment. Because his symptoms were not alleviated and he continued to experience recurrent locking, we performed partial resection of the inferior part of the scapula. Although scapular locking diminished after this procedure, there were still some pain and “catching” between the scapula and the thoracic wall (T6) when he undertook certain movements. No further surgery could be performed, however, because the cancer from the primary lesion had recurred near the previously operated thoracic wall. A procedure for recurrent intrathoracic locking of the scapula was not successful in this case.

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“…6,32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases. 10,13,26 Therefore, the purposes of this study were to (1) report a case and surgical technique for STF using UHMWPE-reinforced suture fixation and (2) perform systematic literature review of Institutional review board approval was not required for this study. scapulothoracic arthrodesis methods evaluating technique, fusion, and reoperation.…”

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confidence: 99%

“… 1 , 2 , 16 , 17 , 18 , 20 , 22 , 23 , 24 , 25 , 28 , 29 , 3 , 31 , 33 , 5 , 8 , 9 , 10 , 11 , 12 , 14 Bony deformities including rib or scapular osteochondromas in multiple hereditary exostoses, glenoid instability, or scapular dislocations have also been indicated as causes. 13 , 15 , 16 , 19 , 22 , 29 If initial management of physical therapy and bracing fail to adequately resolve symptoms and prevent scapular winging, different surgical options can be considered. 23 In cases where conservative measures and other surgical options, such as muscle transfers, have failed, scapulothoracic fusion (STF) or arthrodesis should be considered.…”

mentioning

confidence: 99%

“…The addition of iliac crest autograft or bone chip allograft contributes to successful fusion. 1 , 2 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 3 , 25 , 27 , 28 , 29 , 31 , 33 , 4 , 5 , 7 , 8 , 9 , 11 , 12 More recently, the introduction of ultra-high-molecular-weight polyethylene (UHMWPE)–reinforced suture has offered an alternative to traditional metal cables, having been shown to have greater strength than stainless steel as fracture tension bands. 6 , 32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases.…”

mentioning

confidence: 99%

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Scapulothoracic fusion using nonabsorbable suture fixation: surgical technique and review of the literature

Scollan

Chughtai

Evans

et al. 2021

JSES Reviews, Reports, and Techniques

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Background: Historically, scapulothoracic fusion (STF) is performed using steel wire and plate construct fixation. The purpose of this study is to report a recent fusion achieved through ultra-high-molecularweight polyethylene-reinforced suture fixation as well as to perform a systematic literature review of techniques, fusion rates, complications, and reoperation. Methods: Patient data were gathered from chart review and clinical encounters. For the review, MED-LINE, Embase, and Ovid databases were queried for STF cases. Thirty articles reporting on 386 fusion procedures were included. Results: Including this patient, 5 of 387 (1.3%) STFs have been attempted with fiber suture. Fusion rates of metal-only constructs is 90.8% (346 of 381) with 11.3% (43 of 381) requiring wire removal or trimming because of symptomatic hardware and 7% (27 of 381) causing a postoperative pneumothorax. Although a small sample size, all fiber-suture constructs have achieved union without implant removal and without pneumothorax development. In this patient, fusion was determined radiographically at 6 months with substantial improvement in pain level and function. Conclusion: Scapulothoracic fusion has benefit to patients to have failed other management options for winged scapula, most commonly those with neurologic trauma or facioscapulohumeral muscular dystrophy. With advancements in surgical options, fiber-suture offers an alternative to steel wire to achieve fusion. Further cases with longer term follow-up are needed to determine if significant differences in outcomes exist between constructs.

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Scapulothoracic fusion for low-energy intrathoracic scapula dislocation: a report of two cases

Cited by 3 publications

References 15 publications

Scapular dislocation following radical surgical excision of lung sarcomatoid carcinoma: A rare case report

Scapular dislocation following radical surgical excision of lung sarcomatoid carcinoma: A rare case report

Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection

Scapulothoracic fusion using nonabsorbable suture fixation: surgical technique and review of the literature

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