van Riet Roger P, Van Glabbeek Francis
Department of Orthopaedic Surgery and Traumatology University Hospital Antwerp, Edegem, Belgium.
Acta Orthop Belg. 2007 Apr;73(2):252-4.
Painful snapping of the scapula may have an anatomical cause but is usually idiopathic. Most patients respond well to conservative measures such as physiotherapy or non-steroidal anti-inflammatory drugs. Surgery can be performed if conservative treatment is unsuccessful. Conservative measures are less likely to be successful if a clear anatomical cause can be found. Several surgical techniques have been described, ranging from bursectomy to resection of the lesion or of part of the scapula. The lesion is usually resected by an open technique. Scapulothoracic arthroscopy has previously been shown to be a safe procedure with low morbidity in idiopathic cases. A case is described in which painful crepitus of the scapula not responding to conservative measures was caused by an inferior subscapular osteochondroma. Arthroscopic resection of the osteochondroma was performed using a custom, lesion specific, inferior portal. This resulted in restoration of a full and painless function of the shoulder within two weeks of surgery.
肩胛骨疼痛性弹响可能有解剖学原因，但通常是特发性的。大多数患者对物理治疗或非甾体类抗炎药等保守措施反应良好。如果保守治疗不成功，可以进行手术。如果能找到明确的解剖学原因，保守措施成功的可能性较小。已经描述了几种手术技术，从滑囊切除术到病变或部分肩胛骨切除术。病变通常通过开放技术切除。肩胛胸壁关节镜检查以前已被证明在特发性病例中是一种安全的手术，发病率低。本文描述了一例因肩胛下骨软骨瘤导致肩胛骨疼痛性摩擦音且对保守措施无反应的病例。使用定制的、针对病变的下入口进行关节镜下骨软骨瘤切除术。这导致术后两周内肩部功能完全恢复且无痛。
