Department of Cardio-Thoracic Surgery, Shenzhen University General Hospital, Shenzhen, China.
Department of Thoracic Surgery, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, Shenzhen, China.
Medicine (Baltimore). 2024 Jan 12;103(2):e36884. doi: 10.1097/MD.0000000000036884.
Scapular prolapse is a rare complication of thoracotomy. Only a few cases of scapular prolapse after thoracotomy have been reported. Here, we report the case of a 52-year-old male patient who underwent standard posterior thoracotomy for lung sarcomatoid carcinoma invading the left upper chest wall.
The surgery was performed to remove some ribs and chest wall muscles; however, no reconstruction or repair of the chest wall defect was performed. The patient experienced a sharp pain and severe limitation of movement of the left shoulder within 1 month of receiving adjuvant therapy.
The patient was diagnosed with left intrathoracic scapular prolapse after careful consideration of medical history, physical examination, and chest radiography.
We performed closed manual reduction because the patient refused to undergo surgery.
The patient's shoulder pain and movement limitation were significantly relieved, but the symptoms relapsed. After repeated closed manual reduction, the patient was instructed not to abduct the shoulder joint above 90°. The patient did not relapse during a 1-year observation period.
If scapular prolapse occurs, manual or surgical reduction can be selected based on the needs. If a patient refuses to undergo surgery, manual reduction can be an effective treatment method.
肩胛骨突出是开胸术后的一种罕见并发症。仅有少数开胸术后发生肩胛骨突出的病例报道。在此，我们报告了 1 例 52 岁男性患者，因左上胸壁肺肉瘤样癌行标准后外侧开胸术。
手术切除了部分肋骨和胸壁肌肉，但未对胸壁缺损进行重建或修复。辅助治疗后 1 个月，患者出现左肩部剧烈疼痛和严重活动受限。
仔细考虑病史、体格检查和胸部 X 线片后，诊断为左胸腔内肩胛骨突出。
因患者拒绝手术，我们行闭合手法复位。
患者肩部疼痛和活动受限明显缓解，但症状复发。经反复闭合手法复位后，嘱患者肩关节外展不超过 90°。在 1 年的观察期内，患者未复发。
如果发生肩胛骨突出，可根据需要选择手法复位或手术复位。如果患者拒绝手术，手法复位是一种有效的治疗方法。
