subscapular

  • 文章类型: Journal Article
    肩胛骨下的肌内脓肿是一种罕见的现象,但对于外科医生来说是重要的病理,因为临床恶化可能会迅速且诊断困难。该表现通常模仿具有亚急性肩痛和僵硬的其他常见肩关节病变。早期诊断,抗生素和外科引流对减少关节的传播和破坏至关重要。
    对PubMed和GoogleScholar数据库的搜索确定了肩胛骨下肌内脓肿的病例。收集到的每个病例的数据包括患者的人口统计学,介绍,病理学,手术治疗和结果。作者报告了另一例肩胛骨下脓肿病例。
    我们发现了17例肩胛骨下脓肿,文献中的16个和作者描述的一个案例。17例中有16例(94.1%)在就诊前平均6.7天内出现肩痛和活动范围恶化。使用的手术方法包括后下入路,三角肌胸肌入路和后下外侧入路。
    从有关肩胛骨下肌内脓肿的有限数据,作者提出了以下建议:(1)经验性抗生素涵盖金黄色葡萄球菌+/-耐甲氧西林金黄色葡萄球菌,(2)在所有情况下都应引流;(3)保留肌腱的方法可以在肩胛骨下间隙的大多数位置进入脓肿。
    UNASSIGNED: An intramuscular abscess of the subscapularis is a rare phenomenon but important pathology for surgeons to be aware of because clinical deterioration can be rapid and diagnosis difficult. The presentation often mimics other common shoulder pathologies with subacute shoulder pain and stiffness. Early diagnosis, antibiotics and surgical drainage are critical to reduce the spread and joint destruction.
    UNASSIGNED: A search of PubMed and Google Scholar databases identified cases of subscapular intramuscular abscess. Data collected about each case included patient demographics, presentation, pathology, surgical treatment and outcome. The authors report one additional subscapular abscess case.
    UNASSIGNED: Data from 17 cases of subscapular abscess were found, 16 in the literature and one case described by the authors. Sixteen of 17 cases (94.1%) presented with shoulder pain and reduced range of motion worsening over a mean of 6.7 days prior to presentation. Surgical approaches utilised included a posterior inferomedial approach, deltoid-pectoral approach and one posterior inferolateral approach.
    UNASSIGNED: From the limited data available regarding subscapular intramuscular abscess, the authors make the following recommendations: (1) Empirical antibiotics covering Staphylococcus aureus +/- methicillin-resistant Staphylococcus aureus, (2) drainage is indicated in all cases; and (3) tendon-sparing approaches can access an abscess in most locations within the subscapular space.
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  • 文章类型: Journal Article
    BACKGROUND: The rarity and anatomical complexity of brachial plexus tumors (BPTs) impose many challenges onto surgeons performing surgical resections, especially when these tumors invade the cervicothoracic spine. Treatment choices and surgery outcomes heavily depend on anatomical location and tumor type.
    METHODS: The authors performed an extensive review of the published literature (PubMed) focusing on \"brachial plexus tumors\" that identified invasion of the cervicothoracic spine.
    RESULTS: The search yielded 2774 articles pertaining to \"brachial plexus tumors\". Articles not in the English language or involving cervicothoracic spinal invasion were excluded.
    CONCLUSIONS: Recent research has shown that the most common method used to resect tumors of the proximal roots is the dorsal subscapular approach. Despite its association with high morbidity rate, this technique offers excellent exposure to the spinal roots and intraforaminal portion of the spinal nerve. The dorsal approach is used to resect recurrent lower trunk tumors and dumbbell-shaped neurofibromas, yet it is also the least common overall approach used in brachial plexus tumor resections. The ventral or anterior technique is commonly used to resect tumors at the cord to division level, and root to trunk level. Motor complications, transient nerve palsy, and bleeding are among the most common complications of the anterior supraclavicular approach. Further controlled studies are needed to fully determine the optimal surgical approach used to obtain the best outcomes and least complications for each type of brachial plexus tumor.
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  • 文章类型: Case Reports
    UNASSIGNED: Elastofibroma dorsi (ED) is a benign slow growing soft tissue tumor that is most frequently located subscapular. The prevalence is estimated to be 2% on imaging studies in individuals over 60 years old and might occur bilaterally. The etiology, however, remains unclear.
    UNASSIGNED: This report presents the case of a man with bilateral ED. He first presented at the age of 49 with a subscapular ED on the right side and again at the age of 53 with a subscapular ED on the left side. At both times, diagnosis of ED was histopathologically confirmed after surgical resection. And, again at both times, the postoperative course was characterized by seroma development.
    UNASSIGNED: This report shows a brief review of literature on ED. It contains a summary of the current data on prevalence, etiology, clinical presentation, diagnosis, histopathological findings, surgical treatment and postoperative management. It also includes a flowchart for diagnostic and therapeutic approach.
    UNASSIGNED: ED might present bilaterally, though not necessarily affecting both sides simultaneously. In order to diagnose ED MRI is ought to be sufficient. Invasive procedures, i.e. complete surgical excision, are mandatory to treat symptomatic ED, although such surgical procedures are often complicated by seroma formation.
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  • 文章类型: Case Reports
    Subscapular space is an uncommon site for abscess formation. There are only seven reports of subscapular abscesses in the literature. Only three of these cases are reported in children. We recently treated a child with subscapular abscess. We performed the literature search using a combination of the keywords: subscapular, scapular, abscess and infection. One case was diagnosed on post-mortem autopsy, and only three of these cases are reported in children. The organism was Staphylococcus aureus in five cases (two were methicillin-resistant S. aureus), Haemophilus influenzae in one case, and no organism was grown in the last case. (Patient received a course of empirical antibiotics and samples did not grow any organism.) We describe a case of spontaneous subscapular abscess in a 7-year-old boy. The abscess was visualised on magnetic resonance imaging (MRI), and the organism was identified as S. aureus bacteria. The abscess was treated surgically with debridement and antibiotics, and the patient had full recovery with no subsequent effects. Subscapular abscess needs high index of suspicion and early imaging investigation. MRI is the modality of choice for accurate diagnosis. Early intervention leads to favourable outcome, while delays in diagnosis can be fatal.
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