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肩胛骨骨软骨瘤的保守康复方案:一例报告

Conservative Rehabilitation Program for Osteochondroma of the Scapula: A Case Report.

作者信息

Burile Ghanishtha C, Ramteke Swapnil U

机构信息

Sports Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Apr 15;16(4):e58293. doi: 10.7759/cureus.58293. eCollection 2024 Apr.

DOI:10.7759/cureus.58293
PMID:38752046
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11094527/
Abstract

One of the most frequent cartilage-capped outgrowths that develop beneath the periosteum due to cartilage ossification is osteochondroma. The second decade of life is noted as the most prevalent age of presentation. This case report looks at an uncommon osteochondroma presentation in a 20-year-old female with swelling along the right inferomedial border of the scapula. The patient presented with complaints of difficulty in daily activities and exhibited altered posture, decreased range of motion (ROM), muscle weakness, and altered shoulder function. The clinical assessment highlighted restricted shoulder and cervical ROM and muscle weakness in the trapezius, rhomboids, serratus anterior, and other surrounding muscles. Magnetic resonance imaging revealed an inferomedial bony outgrowth indicative of osteochondroma. A comprehensive physiotherapy intervention protocol for eight weeks was designed to alleviate pain, improve mobility, restore ROM, strengthen weakened muscles, correct posture, and enhance functions that were restricted. The protocol encompassed various techniques, such as muscle energy techniques (MET), proprioceptive neuromuscular facilitation (PNF), cold therapy, stretching, scapular mobilization, resistance exercises with TheraBand, postural correction exercises, ergonomic adjustments, scapular stabilization exercises, and 'J'-taping to aid in muscle activation and address rounded shoulder posture. Outcome measures for cervical and shoulder ROM and strength were measured to note the progression after rehabilitation. The case report emphasizes the importance of a tailored physiotherapy rehabilitation protocol in managing osteochondroma-related symptoms, showing the potential benefits of multifaceted interventions in alleviating pain, improving function, and boosting the quality of life for individuals with similar presentations.

摘要

由于软骨骨化而在骨膜下形成的最常见的带软骨帽的外生骨疣之一是骨软骨瘤。第二个十年被认为是最常见的发病年龄。本病例报告研究了一名20岁女性肩胛骨右内下边界处肿胀的罕见骨软骨瘤表现。患者主诉日常活动困难,出现姿势改变、活动范围(ROM)减小、肌肉无力和肩部功能改变。临床评估突出显示肩部和颈椎ROM受限,以及斜方肌、菱形肌、前锯肌和其他周围肌肉的肌肉无力。磁共振成像显示有一个内下骨性外生骨疣,提示为骨软骨瘤。设计了一个为期八周的综合物理治疗干预方案,以减轻疼痛、改善活动能力、恢复ROM、增强虚弱的肌肉、纠正姿势并增强受限的功能。该方案包括各种技术,如肌肉能量技术(MET)、本体感觉神经肌肉促进法(PNF)、冷疗、拉伸、肩胛骨松动术、使用弹力带的抗阻运动、姿势矫正运动、人体工程学调整、肩胛骨稳定运动以及“J”形贴扎,以帮助激活肌肉并解决圆肩姿势问题。测量了颈椎和肩部ROM及力量的结果指标,以记录康复后的进展情况。该病例报告强调了量身定制的物理治疗康复方案在管理骨软骨瘤相关症状方面的重要性,显示了多方面干预在减轻疼痛、改善功能和提高有类似表现个体的生活质量方面的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/456c43193356/cureus-0016-00000058293-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/33ee714eb1a7/cureus-0016-00000058293-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/10a4f998c73c/cureus-0016-00000058293-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/c6df6cb463ea/cureus-0016-00000058293-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/cd3008b2b03e/cureus-0016-00000058293-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/fb55c356a431/cureus-0016-00000058293-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/a0fc2e9d9722/cureus-0016-00000058293-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/456c43193356/cureus-0016-00000058293-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/33ee714eb1a7/cureus-0016-00000058293-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/10a4f998c73c/cureus-0016-00000058293-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/c6df6cb463ea/cureus-0016-00000058293-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/cd3008b2b03e/cureus-0016-00000058293-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/fb55c356a431/cureus-0016-00000058293-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/a0fc2e9d9722/cureus-0016-00000058293-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/11094527/456c43193356/cureus-0016-00000058293-i07.jpg

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本文引用的文献

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J Orthop Case Rep. 2022 Jul;12(7):34-37. doi: 10.13107/jocr.2022.v12.i07.2906.
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Osteochondroma of the Scapula: A Case Report and Literature Review.肩胛骨骨软骨瘤:一例报告及文献综述
Cureus. 2022 Oct 21;14(10):e30558. doi: 10.7759/cureus.30558. eCollection 2022 Oct.
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