Klippel-Feil syndrome is characterized by congenital fusion of two or more cervical vertebrae, a low hair line at the back of the head, restricted neck mobility, and other congenital anomalies. We report a 16-year-old young man with Klippel-Feil syndrome, Sprengel deformity of the right scapula, thoracic kyphoscoliosis, and mandibular prognathism with an anterior open bite. He was treated with orthodontic treatment and maxillofacial surgery. An anticipated difficult airway due to a short neck with restricted neck movements and extrinsic restrictive lung disease due to severe thoracic kyphoscoliosis increased his anesthesia risk. Due to his deviated nasal septum and contralateral inferior turbinate hypertrophy, we chose awake fiber optic orotracheal intubation followed by submental intubation. Considering the cervical vertebral fusion, he was carefully positioned during surgery to avoid potential spinal injury. He recovered well and his postoperative course was uneventful.
Adolescent ; Anesthesia ; Cervical Vertebrae ; Congenital Abnormalities ; Female ; Genioplasty ; Hair ; Head ; Humans ; Hypertrophy ; Intubation ; Klippel-Feil Syndrome ; Lung Diseases ; Mandible ; Nasal Septum ; Neck ; Open Bite ; Orthognathic Surgery ; Osteotomy ; Prognathism ; Scapula ; Spinal Injuries ; Surgery, Oral ; Turbinates

PURPOSE: The number of coronary interventions is increasing in Korea. Medical team tend to underestimate the radiation that is used during coronary interventions. For this reason if a person who underwent coronary intervention are less likely to be diagnosed with chronic radiodermatitis. METHODS: From March 1, 2012 to February 28, 2017, patients who had a history of coronary intervention visited our plastic surgery clinic with chronic ulceration on the back, shoulders, and scapula. Subjects were classified by age, sex, lesion location, size, medication, time of exposure, onset after last exposure, treatment method, complication, and recurrence. RESULTS: 5 cases were reported, two in the left scapula, one in the right scapular, one in the mid back, and one in the below right axilla. Coronary interventions were performed twice in two patients and three times in a patient. The average exposure time was 84 minutes. The average elapsed time after for last exposure was three years and 3 months ago and ranged from 1 year to 10 years. The size of ulcer lesions was 11.1 cm² on average. All patients underwent debridement of the dead tissue and flap surgery. CONCLUSION: Patients with a history of coronary intervention should be aware of the possibility of chronic radiation dermatitis if they come with chronic scarring or ulcerative chronic wounds with a clear border at the back, shoulders and scapula. So accurate diagnosis based on the patient's medical history is important and awareness of medical team who perform coronary interventions is also necessary.
Axilla ; Cicatrix ; Debridement ; Dermatitis ; Diagnosis ; Fluoroscopy ; Humans ; Korea ; Methods ; Radiodermatitis* ; Recurrence ; Scapula ; Shoulder ; Surgery, Plastic ; Ulcer ; Wounds and Injuries

We, herein, present a patient with no history of trauma who developed shoulder pain after undergoing low-voltage electric shock. According to the computed tomography, there was a multi-segmental fracture that extended into the glenoid cavity of the left scapula. A good outcome was obtained after open reduction and internal fixation. Emergency physicians should be aware of the possibility of scapular fracture extending into the glenoid cavity, especially in patients with shoulder pain after electrical injury.
Electric Injuries ; Emergencies ; Glenoid Cavity* ; Humans ; Scapula ; Shock* ; Shoulder Pain

A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up.
Diaphragm ; Emergencies ; Follow-Up Studies ; Hemodynamics ; Hemorrhage ; Humans ; Liver ; Middle Aged ; Multiple Trauma ; Rehabilitation ; Resuscitation ; Scapula ; Steel* ; Thoracic Injuries ; Thoracic Wall ; Trauma Centers

OBJECTIVETo explore surgical therapeutic strategies and clinical effects for floating shoulder injury.

METHODSFrom March 2010 to December 2013, 12 patients with floating shoulder injury were treated by open reduction and plate screw fixation,including 10 males and 2 females aged from 22 to 45 years old with an average of 31.7 years old. Preoperative X-ray and CT showed 11 cases were ipsilateral clavicle fracture with scapular neck fractures, 1 case was scapular neck fracture with ipsilateral acromioclavicular dislocation. Postoperative complications were observed and Herscvici functional scoring were used to evaluate clinical effects.

RESULTSTwelve patients were followed up from 8 to 26 months (averaged 15 months). All patients obtained bone union, and no inflammation, loosening and breakage of plate and screw were found. According to Herscvici scoring, 9 cases got excellent results, 2 good and 1 moderate.

CONCLUSIONReconstruction of anatomical structure and stability of floating shoulder joint injury could shorten time of shoulder joint brake and fixation, then got excellent clinical outcomes.

Adult ; Clavicle ; injuries ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Scapula ; injuries

Winging of scapula occurs most commonly due to injury to long thoracic nerve supplying serratus anterior muscle. Traumatic injury to serratus anterior muscle itself is very rare. We reported a case of traumatic winging of scapula due to tear of serratus anterior muscle in a 19-year-old male. Winging was present in neutral position and in extension of right shoulder joint but not on "push on wall" test. Patient was managed conservatively and achieved satisfactory result.
Electromyography ; Humans ; Lifting ; adverse effects ; Magnetic Resonance Imaging ; Male ; Scapula ; physiopathology ; Superficial Back Muscles ; injuries ; physiopathology ; Young Adult

OBJECTIVETo explore clinical effects of internal fixation in treating displaced clavicle fracture combined with coracoid process.

METHODSFrom January 2005 to July 2012, 9 patients with displaced clavicle fracture combined with coracoid process were treated by internal fixation. Among them, there were 6 males and 3 females with an average age of 40.1 (ranged from 20 to 57) years old. According to Eyres classification: 3 cases were type II B, 1 case was type II A, 3 cases were type III B, and 2 cases were type V A. All patients had history of injury, and diagnosed as coracoid fracture X-ray and CT before operation. Herscovici criteria was used to evaluate function of shoulders joint after operation.

RESULTSSeven of 9 patients were followed up from 6 to 18 (averaged 11) months. The incisions were healed at stage I, coracoid process obtained bony healing, and reduction of acromioclavicular joint well. According to Herscovici criteria, 6 patients got excellent results and 1 in good.

CONCLUSIONInternal fixation for the treatment of displaced clavicle fracture combined with coracoid process could restore physiological anatomical position of coracoid process, and benefit for recovery of limb function.

Adult ; Clavicle ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Scapula ; injuries ; Shoulder Joint ; injuries

Acupuncture Therapy ; Adult ; Fasciitis ; therapy ; Female ; Humans ; Male ; Scapula ; injuries ; Young Adult

INTRODUCTIONDetailed anatomical knowledge of the suprascapular notch (SSN) is important for the management of entrapment neuropathy and interventional procedures. The objective of the present study was to collect data on the morphological features and anatomical variations of the SSN in an Indian population.

METHODSWe studied 268 human scapulae of unknown sex (126 right-sided, 142 left-sided) taken from the Department of Anatomy, Dayanand Medical College and Hospital, India. SSNs were classified as either type I, II, III, IV or V, based on the shape of the inferior border of the incisura, and comparison of the SSN's vertical and transverse diameters. The shape of the SSN (i.e V- or U-shaped), if present, was also recorded.

RESULTSType II SSN was the most common (50.00%), followed by type I, type IV and type III (32.46%, 9.70% and 7.84%, respectively). For right-sided type II SSNs, the transverse and vertical diameters were 9.1 ± 3.2 mm and 5.2 ± 1.9 mm, respectively, while those for left-sided type ll SSNs were 9.2 ± 2.4 mm and 5.1 ± 1.8 mm, respectively. Generally, the transverse diameter of type II SSN was found to be greater than that of type III SSN. The incidence of U-shaped SSN was 51.49%, while that of V-shaped SSN was 2.99%.

CONCLUSIONThis study of the morphometrical characteristics and anatomical variations of SSN provides an anatomical database of SSN in the Indian context. This database will be of use in surgical procedures, as the information can be used to ensure adequate access to and complete decompression of the suprascapular nerve.

Humans ; India ; Nerve Compression Syndromes ; diagnosis ; Scapula ; anatomy & histology ; surgery ; Shoulder Joint ; injuries

Infraglenoid tubercle avulsion fractures are extremely rare injuries. We report a 38-year-old male with glenoid cavity fracture and infraglenoid tubercle avulsion of the left shoulder following a fall from bike. He refused surgery and was treated nonoperatively. Follow-up radiography and CT at 18 months revealed a malunited infraglenoid tubercle with signs of early glenohumeral osteoarthritis. He did not have shoulder instability or pain and had a fair-good functional outcome. There are no previously published data on the anatomic outcome of nonoperatively treated displaced infraglenoid tubercle avulsion fractures based on CT.
Adult ; Bicycling ; injuries ; Humans ; Male ; Scapula ; injuries ; Shoulder Fractures ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed