Static winging of the scapula caused by osteochondroma in adults: a case series

Abstract

IntroductionAlthough palsy of the long thoracic nerve is the classical pathogenesis of winging scapula, it may also be caused by osteochondroma. This rare etiopathology has previously been described in pediatric patients, but it is seldom observed in adults.Case presentationWe describe three cases of static scapular winging with pain on movement.Case 1 is a Caucasian woman aged 35 years with a wing-like prominence of the medial margin of her right scapula due to an osteochondroma originating from the ventral omoplate. Histopathological evaluation after surgical resection confirmed the diagnosis. The postoperative course was unremarkable without signs of recurrence on examination at 2 years.Case 2 is a Caucasian woman aged 39 years with painful scapula alata and neuralgic pain projected along the left ribcage caused by an osteochondroma of the left scapula with contact to the 2nd and 3rd rib. Following surgical resection, the neuropathic pain continued, demanding neurolysis of the 3rd and 4th intercostal nerve after 8 months. The patient was free of symptoms 2 years after neurolysis.Case 3 is a Caucasian woman aged 48 years with scapular winging due to a large exostosis of the left ventral scapular surface with a broad cartilaginous cap and a large pseudobursa. Following exclusion of malignancy by an incisional biopsy, exostosis and pseudobursa were resected. The patient had an unremarkable postoperative course without signs of recurrence 1 year postoperatively.Based on these cases, we developed an algorithm for the diagnostic evaluation and therapeutic management of scapula alata due to osteochondroma.ConclusionsOrthopedic surgeons should be aware of this uncommon condition in the differential diagnosis of winged scapula not only in children, but also in adult patients.

Solitary osteochondroma of the Scapula: an uncommon localization

“…Mrad-Dali et al, reported 7 cases out of 95 cases [3]. About 45 cases were also published separately by different authors [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Ventral localization like our case was repoted in two cases [19].…”

Osteochondromas originating from unusual locations complicating orthopedic discipline: case series

“…In these 20 articles, some reported surgical techniques. [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] Similarly, our patient also had snapping scapula and pseudo-winging symptoms. However, perioperative images and radiological studies were demonstrative and didactic.…”

“…Plain radiographs (anteroposterior and lateral view) of the leg with knee revealed a large cauliflower-like growth arising from proximal fibula ( Figure 4 [13][14][15][16][17][18][19] 15 articles (except surgical technique reports) [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] 14 articles in literature [20][21][22][23][24][25][26][27][28][29][30][31][32][33] 14 articles in literature [20][21][22][23][24][25][26][27][28][29][30][31][32]…”

Imaging of benign complications of exostoses of the shoulder, pelvic girdles and appendicular skeleton

“…Mechanical effects of impingement are limited range of motion, friction and trigger tendons or ligaments and early osteoarthritis. The scapula is involved in 3.0 to 4.6% of complications [7,8]. Usually located at the anterior surface of the scapula, they are often symptomatic.…”