Wang Zhenyu, Zhang Chenke, Zheng Guo, Yang Fangcheng, Hou Tianyong, Zhou Binghua
Sports Medicine Center, First affiliated Hospital of Army Medical University.
Orthopaedic department, First affiliated Hospital of Army Medical University;
J Vis Exp. 2025 May 16(219). doi: 10.3791/68253.
Scapular winging caused by paralysis of the rhomboid muscle is a relatively uncommon condition in shoulder outpatient. Despite the paucity, it presents as a debilitating condition with sequelae of poor function and deconditioning. Reinforcement reconstruction and restoring the rhomboid muscle dynamic presents a biomechanical treatment option for patients because of paralyzed rhomboids. Building upon our previous research demonstrating successful myointegration of autologous fascia lata grafts, we introduce an innovative reconstruction surgical technique utilizing these grafts to address rhomboid muscle paralysis. We performed reinforcement reconstruction using fascia lata autograft on a patient for painful scapular winging caused by paralyzed rhomboids and aimed to achieve a normal rhythm of the scapulothoracic joint. The procedure achieved functional restoration and scapular stabilization through reinforcement reconstruction. Postoperative assessment at 6 weeks revealed a full shoulder range of motion, absence of scapulothoracic discomfort, and resolution of scapular winging confirmed by clinical testing. This advancement provides shoulder orthopedic surgeons with a novel biomechanical solution for managing refractory scapular winging.
菱形肌麻痹引起的肩胛翼状肩在肩部门诊中是一种相对少见的病症。尽管病例不多，但它表现为一种使人衰弱的病症，伴有功能不佳和身体机能下降的后遗症。由于菱形肌麻痹，加强重建并恢复菱形肌的动力为患者提供了一种生物力学治疗选择。基于我们之前证明自体阔筋膜移植成功实现肌整合的研究，我们引入了一种创新的重建手术技术，利用这些移植来解决菱形肌麻痹问题。我们对一名因菱形肌麻痹导致疼痛性肩胛翼状肩的患者进行了自体阔筋膜移植加强重建，旨在实现肩胛胸壁关节的正常节律。该手术通过加强重建实现了功能恢复和肩胛稳定。术后6周的评估显示肩部活动范围完全正常，肩胛胸壁无不适，临床检查证实肩胛翼状肩已消失。这一进展为肩部整形外科医生提供了一种治疗难治性肩胛翼状肩的新型生物力学解决方案。
