The online version of this article (doi:10.1186/1752-1947-6-363) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
PO carried out the analysis, review of the literature, and writing of the manuscript. KA participated in research, writing of the manuscript, and review of the literature. EF and DK performed surgery and participated in the review of the manuscript. HM conceived the study, carried out surgery, and participated in research as well as in writing and reviewing the manuscript. All authors read and approved the final manuscript.
Although palsy of the long thoracic nerve is the classical pathogenesis of winging scapula, it may also be caused by osteochondroma. This rare etiopathology has previously been described in pediatric patients, but it is seldom observed in adults.
We describe three cases of static scapular winging with pain on movement.
Case 1 is a Caucasian woman aged 35 years with a wing-like prominence of the medial margin of her right scapula due to an osteochondroma originating from the ventral omoplate. Histopathological evaluation after surgical resection confirmed the diagnosis. The postoperative course was unremarkable without signs of recurrence on examination at 2 years.
Case 2 is a Caucasian woman aged 39 years with painful scapula alata and neuralgic pain projected along the left ribcage caused by an osteochondroma of the left scapula with contact to the 2nd and 3rd rib. Following surgical resection, the neuropathic pain continued, demanding neurolysis of the 3rd and 4th intercostal nerve after 8 months. The patient was free of symptoms 2 years after neurolysis.
Case 3 is a Caucasian woman aged 48 years with scapular winging due to a large exostosis of the left ventral scapular surface with a broad cartilaginous cap and a large pseudobursa. Following exclusion of malignancy by an incisional biopsy, exostosis and pseudobursa were resected. The patient had an unremarkable postoperative course without signs of recurrence 1 year postoperatively.
Based on these cases, we developed an algorithm for the diagnostic evaluation and therapeutic management of scapula alata due to osteochondroma.
Orthopedic surgeons should be aware of this uncommon condition in the differential diagnosis of winged scapula not only in children, but also in adult patients.
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- Static winging of the scapula caused by osteochondroma in adults: a case series
- BioMed Central