scapulothoracic

Most subscapularis and serratus anterior muscles lie between the scapula and the thoracic cage. Evaluation of this area in patients with scapulothoracic dyskinesis, snapping scapular syndrome, or interscapular pain can provide valuable information to clinicians. However, ultrasound scanning of pathologies in this area is hindered by anatomical limitations. In this study, we described a simple patient setup position and scanning method for ultrasound evaluation and guided intervention of the subscapularis and serratus anterior muscles between the scapula and thoracic cage...

BACKGROUND: Chronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP. METHODS: Databases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023...

BACKGROUND: The rationale for the Latarjet procedure was described as the "triple blocking" effect. Satisfactory surgical outcomes have been reported after surgery. However, it has been reported that the "triple blocking" effect increases joint stability, but it does not fully restore it. Moreover, the procedure is nonanatomic and concerns remain regarding the effects. The study of scapulohumeral rhythm, which is a clinical parameter used for the functional evaluation of shoulder kinematics, can offer new perspectives on the rationale for the procedure...

BACKGROUND: Computer simulation has indicated a significant effect of scapulothoracic orientation and posture on range of motion (ROM) after reverse total shoulder arthroplasty (RTSA). We analyzed this putative effect on the clinical and radiological outcome post-RTSA. METHODS: We retrospectively assessed 2-year follow-up data of RTSA patients treated at our clinic between 2008 and 2019. Patients were categorized into posture types A, B, and C based on an established method using scapular internal rotation on preoperative cross-sectional imaging...

The trapezius muscle (TRAP) belongs to the scapulothoracic group of muscles, which play a crucial role in the integrity and strength of the upper limb, trunk, head, and neck movements and, thus, in maintaining balance. Combined retrograde tracing (using fluorescent tracer Fast Blue, FB) and double-labelling immunohistochemistry were applied to investigate the chemical coding of motoneurons projecting to the porcine TRAP. FB-positive (FB+) motoneurons supplying the cervical (c-TRAP) and thoracic part (th-TRAP) of the right (injected with the tracer) TRAP were located within the IX-th Rexed lamina in the ipsilateral ventral horn of the grey matter of the spinal medulla...

BACKGROUND: The importance of several scapulothoracic muscles, including trapezius and serratus anterior, in maintaining physiological scapula kinematics has been highlighted in the past. However, the relationship between the scapula and the latissimus dorsi muscle remains unclear. Our clinical surgical observation is that the latissimus dorsi does not directly attach but rather runs superficial to the inferior angle of the scapula. Based on this observation, we hypothesise that the latissimus dorsi creates a dynamic track on which the scapula glides under the muscle belly during elevation of the arm, creating the latissimus-scapula overlap (LSO)...

Scapulothoracic arthrodesis (STA) surgery is performed to stabilize the scapula in patients with facioscapulohumeral dystrophy (FSHD). Postoperative pain could be a major problem even while using erector spinae plane block (ESPB). We performed a preoperative ESPB with an intraoperative ESPB catheter, but rescue analgesia was needed for pain in the periscapular area in the postoperative period. The patient's pain score was reduced by applying an ultrasound-guided dorsal scapular nerve (DSN) and long thoracic nerve (LTN) block...

BACKGROUND: Constitutional static posterior humeral decentering (type C1 according to ABC Classification) has been recognized as a pre-osteoarthritic deformity that may lead to early-onset posterior decentering osteoarthritis at a young age. Therefore, it is important to identify possible associations of this pathologic shoulder condition to find more effective treatment options. PURPOSE: To perform a comprehensive analysis of all parameters reported to be associated with a C1 shoulder-including the osseous shoulder morphology, scapulothoracic orientation, and the muscle volume of the shoulder girdle in a single patient cohort...

INTRODUCTION: Lymphedema in the upper limb as a complication of breast cancer may lead to shoulder pain and dysfunctions. OBJECTIVE: To compare the scapular positioning, the shoulder range of motion, and muscle strength among women undergoing treatment for breast cancer with and without lymphedema and a control group. METHODS: This cross-sectional study evaluated women undergoing treatment for breast cancer (N = 25) and without lymphedema (N = 25), and a control group (N = 25)...

BACKGROUND: Cranio-cervico-mandibular (CCM) malalignment is associated with forward head posture (FHP) and temporomandibular joint (TMJ) disorders and affects masticatory muscles. OBJECTIVE: This randomized, double-blind controlled trial aimed to compare the efficacy of scapula-thoracic (ST) exercises on temporomandibular and cervical joint position sense and postural stability in individuals with CCM malalignment. METHODS: Fourty-nine participants with CCM malalignment were randomly assigned to the ST exercise group (STEG, n= 24) or the control group (CG, n= 25)...

Scapulothoracic dissociation is a rare upper extremity injury caused by high-velocity trauma over anterolateral shoulder leading to disruption of scapulothoracic articulation. It is considered as a limb threatening injury. Very few cases of scapulothoracic dissociation have been reported in medical literature. In this article, we report a unique case of open injury involving laterally displaced and comminuted scapula accompanied by redundant acromioclavicular joint, total brachial plexus injury, and complete transection of brachial artery...

Closed loop kinematic chain approaches are commonly used to assess scapular kinematics but with heterogeneous ellipsoid calibration procedures. This study aimed to assess whether an ellipsoid surface can model the scapulothoracic sliding plane and determine the optimal number of static poses to calibrate the ellipsoid parameters. An intracortical pin with a rigid cluster of four reflective markers was inserted into the left scapular spine of two healthy males (P1 and P2). They performed arm elevations, internal rotations, ball throwing, hockey shooting, and eating movements...

A 74-year-old man with poorly controlled seropositive rheumatoid arthritis was referred for 18F-FDG PET/CT for follow-up of lung cancer, which demonstrated intense FDG activity in atlantoaxial, sternoclavicular, glenohumeral, and hip joints consistent with active rheumatoid arthritis. There was also unexpected intense uptake at scapulothoracic, ischiogluteal, and trochanteric bursae signifying active bursitis.

BACKGROUND: Reversed total shoulder arthroplasty (RTSA) is a standard surgical procedure for the treatment of rotator cuff tear arthropathy (CTA), aimed at restoring active arm elevation. Shoulder elevation relies on both scapulothroacic (ST) and glenohumeral (GH) motion, but RTSA computer planning primarily focuses on the GH joint due to challenges in visualizing scapulothroacic (ST) motion. RESEARCH QUESTION: Does the scapulohumeral rhythm, by means of the relative contributions of ST rotation and GH elevation per degree of arm elevation, in a longitudinal setting for up to two years postoperatively after RTSA for CTA change? METHODS: In a prospective longitudinal study, shoulder kinematics were studied in 20 patients (22 shoulders) before and at three, six, 12, and 24 months after RTSA implantation for CTA...

OBJECTIVE: to analyze the short-term outcomes of an anatomical technique that reconstructs both the acromioclavicular and coracoclavicular ligaments with the help of a tendon allograft for the management of non-acute acromioclavicular dislocations. METHODS: this is a prospective longitudinal study of a case series of subjects with symptomatic non-acute (>3 weeks) acromioclavicular dislocations surgically managed with an anatomical reconstruction of both the acromioclavicular and coracoclavicular ligaments using tibial tendon allografts...

Osteochondromas (OCs) are bone lesions composed of cartilaginous and medullary bone capped with hyaline cartilage. OCs result from the separation of epiphyseal growth plate cartilage, pushing through the periosteal bone cuff. They commonly appear as pedunculated or sessile masses in the metaphysis of long bones and are the most common benign bone tumors. While rare in the scapula, OCs can occur there. Symptoms may arise from fractures, osseous abnormalities, or potential malignant transformation, especially in the presence of hereditary multiple exostoses (HME)...

Scapulothoracic arthrodesis is carried out by fixing the scapula to thoracic ribs which in turn allows the patient suffering from Facioscapulohumeral Muscular Dystrophy to carry out shoulder-joint dependent activities of daily living. A biomechanical analysis of this procedure has not been conducted in the literature and, for the first time, this study investigates the finite element calculated glenohumeral-applied load distributions on ribs by creating a post scapulothoracic arthrodesis model. Three loading directions on the glenohumeral joint are designated: anterior-posterior (AP), superior-inferior (IS), and lateral-medial (ML)...

It is important to discuss the importance of synchronous balance between periscapular muscles for scapulothoracic motion and resultant scapulohumeral rhythm. Abnormalities in this balance can lead to scapular dyskinesia and winging, affecting shoulder motion and leading to impingement. Strategies exist to diagnose and differentiate between pathologies such as muscle paralysis (eg, trapezius or serratus anterior) or overactivity (eg, pectoralis minor). The physician should be aware of the role of diagnostic imaging, as well as the unique considerations for patients with Ehlers-Danlos syndrome...

A comprehensive review of scapular pathologies and their effect on shoulder function is necessary to determine the best treatment options. The coordinated motion between the scapulothoracic and glenohumeral joints is essential for shoulder motion and depends on the balanced activity of the periscapular muscles. Disruption in these muscles can cause abnormal scapular motion and compensatory glenohumeral movements, leading to misdiagnosis or delayed diagnosis. Scapular pathologies can arise from muscle overactivity or underactivity/paralysis, resulting in a range of scapulothoracic abnormal motion (STAM)...

Inferior angle of scapula fractures are rare, and can lead to pain and impaired shoulder function. This report details the cases of two adult patients with inferior angle of scapula fractures who underwent acute surgical reduction and suture repair. In both patients, the avulsed fragment was dislocated and entrapped in the scapulothoracic joint resulting in noticeable crepitations and disturbed scapulothoracic rhythm during active range of motion. After surgery, both patients achieved significant improvements in shoulder function, enabling them to resume their daily activities without limitations...