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改良伊登-兰格手术治疗医源性肩胛外侧缘翼状肩胛

Modified Eden-Lange procedure for iatrogenic lateral scapular winging.

作者信息

Prasetia Renaldi, Rosa Wendy Yolanda, Primadhi Raden Andri, Rasyid Hermawan Nagar

机构信息

Department of Orthopaedics- Traumatology, Faculty of Medicine, University Padjajaran, Hasan Sadikin General Hospital, Bandung, Indonesia.

Department of Orthopaedics- Traumatology, Faculty of Medicine, University Padjajaran, Hasan Sadikin General Hospital, Bandung, Indonesia.

出版信息

Int J Surg Case Rep. 2020;77:129-132. doi: 10.1016/j.ijscr.2020.10.068. Epub 2020 Oct 28.

Abstract

INTRODUCTION

Lateral winging scapula is rare and generated by the trapezius paralysis. It is most likely iatrogenic from procedures involving the posterior cervical triangle. The modified Eden-Lange procedures one of the options by restoring the major actions of a flaccid trapezius. This case report aims to evaluate the outcomes.

CASE REPORT

A 34-year-old female came with right lateral scapular winging after radical neck tumor dissection and miss diagnosed by another hospital and underwent shoulder surgery. We performed a physical examination and showed lateral winging scapula. The best management therapy for this patient used modified Eden-Lange procedure.

DISCUSSION

Conservative treatments for Lateral scapular winging caused by spinal accessory nerve injury might be successful in early 20 months. However, our patient was injured 26 months before surgery which made Eden-Lange Procedures was the best choice for the patient. Modifications to this procedure allowed her to achieve excellent results.

CONCLUSION

Correction of the lateral scapular winging by modified Eden-Lange procedure combined with physical therapy for patient's trapezius palsy to gain adequate stability for daily activities.

摘要

引言

肩胛外侧翼状畸形较为罕见,由斜方肌麻痹引起。极有可能是涉及颈后三角的手术导致的医源性损伤。改良的伊登-兰格手术是恢复松弛斜方肌主要功能的选择之一。本病例报告旨在评估其疗效。

病例报告

一名34岁女性在根治性颈部肿瘤切除术后出现右侧肩胛外侧翼状畸形,在另一家医院被误诊,并接受了肩部手术。我们进行了体格检查,发现存在肩胛外侧翼状畸形。该患者的最佳治疗方法是采用改良的伊登-兰格手术。

讨论

对于由副神经损伤引起的肩胛外侧翼状畸形,保守治疗在伤后20个月内可能有效。然而,我们的患者在手术前已受伤26个月,这使得伊登-兰格手术成为该患者的最佳选择。对该手术的改良使她获得了优异的效果。

结论

采用改良的伊登-兰格手术矫正肩胛外侧翼状畸形,并结合物理治疗患者的斜方肌麻痹,可为日常活动获得足够的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ab9/7649588/54d3dd66a153/gr1.jpg

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