Vail, Colorado.
Arthroscopy. 2020 Dec;36(12):2973-2974. doi: 10.1016/j.arthro.2020.09.010.
Snapping scapula syndrome and scapulothoracic bursitis are rare, often painful or functionally limiting conditions that can present owing to underlying anatomic abnormalities or can be idiopathic in nature. When there are no underlying structural abnormalities, diagnosis can be challenging and frequently patients will present with chronic pain having received multiple diagnostic and treatment modalities with no success. Injections into the scapulothoracic bursa, in conjunction with physical therapy, have been shown to be effective for the patient with snapping scapula syndrome and/or scapulothoracic bursitis, when recognized. Yet, some cases are recalcitrant to conservative treatment, and surgical intervention is required. As with any procedure, patient selection for surgical intervention is critical and based on the diagnostic workup-particularly, the response to diagnostic or therapeutic injections. The best surgical outcomes may be achieved in patients who receive bursectomy in conjunction with partial scapulectomy, and negative prognostic factors include older age, lower preoperative psychological score, and longer duration of symptoms.
弹响肩胛综合征和肩胛胸壁囊炎是罕见的，常伴有疼痛或功能受限的病症，可能由于潜在的解剖异常引起，也可能是特发性的。当不存在潜在的结构异常时，诊断可能具有挑战性，并且经常有慢性疼痛的患者接受了多种诊断和治疗方式，但均不成功。对于弹响肩胛综合征和/或肩胛胸壁囊炎患者，当确诊后，肩胛胸囊内注射联合物理治疗已被证明是有效的。然而，一些病例对保守治疗有抗药性，需要手术干预。与任何手术一样，手术干预的患者选择非常关键，这取决于诊断性检查结果，尤其是对诊断性或治疗性注射的反应。在接受肩胛下囊切除术和部分肩胛切除术的患者中，可能获得最佳的手术效果，而预后不良的因素包括年龄较大、术前心理评分较低和症状持续时间较长。
