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一名既往健康的10岁男孩双侧肩胛翼状肩胛的手术治疗:病例报告

Surgical management of bilateral scapular winging in a previously healthy 10-year-old boy: A case report.

作者信息

Ibdah Mohammad G, Tos Salem M, Giacaman Narmeen, Ass'ad Omar M, Saa Husam A T

机构信息

Al-Quds University, College of Medicine, Palestine.

Al Makassed Hospital, Jerusalem, Palestine.

出版信息

Ann Med Surg (Lond). 2022 Aug 19;81:104443. doi: 10.1016/j.amsu.2022.104443. eCollection 2022 Sep.

Abstract

INTRODUCTION

Scapular winging is a pathological condition that occurs due to dysfunction of any scapulothoracic muscles, most commonly the serratus anterior which is innervated by long thoracic nerve.

CASE PRESENTATION

Herein, we report a 10-year-old boy presented with bilateral scapular winging for a few months, associated with vague discomfort upon shoulder movements. After taking history and performing physical examination and tests as electromyography, he was diagnosed with idiopathic bilateral scapular winging as there was no obvious cause or risk factor for his bilateral scapular winging.

DISCUSSION

Scapular winging causes decrease strength and range of motion of the shoulder, the usual complain of patients is discomfort or the unpleasant cosmetic appearance of scapular prominence, this condition, if left untreated, can cause various negative consequences on the shoulder joint, detailed history and physical exam reinforced by electromyography are crucial in determining the cause of winging, as it has many causes, initial management can be conservative, but various surgical approaches have been described for more severe cases which compromise shoulder function, choice of the surgical approach depends on the underlying cause and overall clinical picture of the patient.

CONCLUSION

bilateral scapular winging is rare condition, only 26th cases were reported in literature, it occurs due to multiple causes, treatment can be conservative at early stages, but surgical option should be considered when shoulder function and strength become compromised.

摘要

引言

肩胛翼状突出是一种由于任何肩胛胸壁肌肉功能障碍而出现的病理状况,最常见的是由胸长神经支配的前锯肌。

病例报告

在此,我们报告一名10岁男孩,双侧肩胛翼状突出已有数月,肩部活动时伴有模糊的不适感。在询问病史、进行体格检查以及肌电图等检查后,由于其双侧肩胛翼状突出没有明显病因或危险因素,他被诊断为特发性双侧肩胛翼状突出。

讨论

肩胛翼状突出会导致肩部力量减弱和活动范围受限,患者通常的主诉是不适或肩胛突出的不良外观,这种情况若不治疗,会对肩关节造成各种负面后果,详细的病史、体格检查以及肌电图检查对于确定翼状突出的病因至关重要,因为其病因众多,初始治疗可以是保守的,但对于更严重的、影响肩部功能的病例,已有多种手术方法被描述,手术方法的选择取决于潜在病因和患者的整体临床表现。

结论

双侧肩胛翼状突出是一种罕见病症,文献中仅报道了26例,其由多种原因引起,早期治疗可以是保守的,但当肩部功能和力量受到影响时应考虑手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/700a/9486570/10ba5c689acf/gr1.jpg

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