Department of Orthopaedic Surgery, University of Michigan Health System, 2912 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5328.
Department of Orthopedic Surgery, University of Illinois at Chicago, 835 South Wolcott Avenue, Room E270, M/c 844, Chicago, IL 60612. E-mail address for D. Savin:
J Bone Joint Surg Am. 2015 Oct 21;97(20):1708-16. doi: 10.2106/JBJS.O.00727.
Scapular winging is a rare, underreported, and debilitating disorder that produces abnormal scapulothoracic kinematics, which can lead to shoulder weakness, decreased range of motion, and substantial pain. Although there are numerous underlying etiologies, injuries to the long thoracic nerve or spinal accessory nerve are the most common, with resultant neuromuscular imbalance in the scapulothoracic stabilizing muscles. Early diagnosis followed by initiation of a treatment algorithm is important for successful outcomes. Most cases resolve with nonsurgical management. However, in patients with persistent symptoms despite nonsurgical management, appropriate dynamic muscle transfers can effectively treat the scapular winging, with good clinical outcomes.
肩胛骨翼状是一种罕见、报道较少且使人虚弱的疾病,会导致肩胛骨胸壁运动异常,从而导致肩部无力、活动范围减小和严重疼痛。尽管有许多潜在的病因,但最长胸神经或副神经的损伤最为常见,导致肩胛骨胸壁稳定肌的神经肌肉失衡。早期诊断并开始治疗方案对于获得良好的治疗效果很重要。大多数病例通过非手术治疗即可缓解。然而,对于那些尽管接受了非手术治疗但仍有持续症状的患者,适当的动力肌转移可以有效地治疗肩胛骨翼状畸形,且临床效果良好。