Vitale Kenneth C, Jimenez Arthur
Department of Rehabilitation, NYU School of Medicine, NYU Hospital for Joint Diseases, New York, NY 10003, USA.
Am J Phys Med Rehabil. 2009 Apr;88(4):267-71. doi: 10.1097/PHM.0b013e31819c5901.
An 84-yr-old man presented with right posterior shoulder pain and growing mass. Shoulder range of motion was limited in forward elevation and abduction; result of the neurologic testing was normal. Radiologic workup showed an irregular mass resembling Paget's disease or sarcoma. On surgical inspection, a 16-cm hemorrhagic mass, occupying the entire scapula, was identified. Patient underwent tumor resection and scapulectomy. Postoperatively, he started a rehabilitation program. With attempted ambulation, patient exhibited strong tendencies to lean rightward, walked in circles, and risking fall. The gait abnormality could not be corrected and acute inpatient rehabilitation admission was recommended. A unique rehabilitation program was developed to correct gait deviation, improve balance, and compensate for deficits. After a comprehensive inpatient rehabilitation, the patient was successfully discharged home. We present a review of scapulectomy, postoperative care, and a recommended rehabilitation program.
一名84岁男性因右肩后部疼痛和肿物增大前来就诊。肩部活动范围在前屈和外展时受限；神经学检查结果正常。影像学检查显示有一个不规则肿物，类似佩吉特病或肉瘤。手术检查时，发现一个16厘米的出血性肿物，占据了整个肩胛骨。患者接受了肿瘤切除和肩胛骨切除术。术后，他开始了康复计划。在尝试行走时，患者表现出强烈的向右倾斜倾向，走路打圈，并有跌倒风险。步态异常无法纠正，建议急性住院康复治疗。制定了一个独特的康复计划来纠正步态偏差、改善平衡并弥补功能缺陷。经过全面的住院康复治疗后，患者成功出院回家。我们对肩胛骨切除术、术后护理及推荐的康复计划进行了综述。
