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Published in: Surgical and Radiologic Anatomy 1/2014

01-01-2014 | Original Article

Bony structures related to snapping scapula: correlation to gender, side and age

Authors: Trifon Totlis, George A. Konstantinidis, Marinos T. Karanassos, George Sofidis, Nikolaos Anastasopoulos, Konstantinos Natsis

Published in: Surgical and Radiologic Anatomy | Issue 1/2014

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Abstract

Purpose

This study aimed at summarizing the non-pathologic bony structures which are involved in the pathogenesis of snapping scapula and evaluate their incidence, morphology and correlation to gender, side and age.

Methods

The angulation in the sagittal plane between the supraspinatus and infraspinatus portion of the medial border was measured in 140 dried scapulae. In 264 dried scapulae the medial scapular border morphology was classified into three types and the presence of the Luschka’s tubercle and the teres major tubercle or process was recorded. Correlation to gender, side and age was examined using SPSS.

Results

The mean angulation between the supraspinatus and infraspinatus portion of the medial border was 154.6° ± 8.8°. Τhe medial scapular border was straight in 99 (37.5 %), convex in 135 (51.1 %) and concave in 30 bones (11.4 %). The Luschka’s tubercle was present in eight bones (3 %), while teres major tubercle was found in 114 scapulae (43.2 %). A teres major process was present in 18 bones (6.8 %). The process was curved towards the chest wall in nine bones (3.4 %), while in the other nine scapulae (3.4 %) it had no curvature.

Conclusions

The non-pathologic bony structures which predispose to snapping scapula are not rare and include the concave medial scapular border, the Luschka’s tubercle and the teres major process curved towards the chest wall. Orthopaedic surgeons should bear in mind these non-pathologic bony structures in order not to be overlooked during the diagnostic procedure of a snapping scapula since they usually require surgical treatment.
Literature
1.
go back to reference Aggarwal A, Wahee P, Harjeet, Aggarwal AK, Sahni D (2011) Variable osseous anatomy of costal surface of scapula and its implications in relation to snapping scapula syndrome. Surg Radiol Anat 33:135–140 Aggarwal A, Wahee P, Harjeet, Aggarwal AK, Sahni D (2011) Variable osseous anatomy of costal surface of scapula and its implications in relation to snapping scapula syndrome. Surg Radiol Anat 33:135–140
2.
go back to reference Boinet M (1867) Snapping scapula. Bull Soc Imp Chir (2nd ser) 8:458 Boinet M (1867) Snapping scapula. Bull Soc Imp Chir (2nd ser) 8:458
3.
go back to reference Boyle MJ, Misur P, Youn SM, Ball CM (2012) The superomedial bare area of the costal scapula surface: a possible cause of snapping scapula syndrome. Surg Radiol Anat. doi:10.1007/s00276-012-1007-y Boyle MJ, Misur P, Youn SM, Ball CM (2012) The superomedial bare area of the costal scapula surface: a possible cause of snapping scapula syndrome. Surg Radiol Anat. doi:10.​1007/​s00276-012-1007-y
4.
go back to reference Carlson HL, Haig AJ, Stewart DC (1997) Snapping scapula syndrome: three case reports and an analysis of the literature. Arch Phys Med Rehabil 78:506–511PubMedCrossRef Carlson HL, Haig AJ, Stewart DC (1997) Snapping scapula syndrome: three case reports and an analysis of the literature. Arch Phys Med Rehabil 78:506–511PubMedCrossRef
5.
go back to reference Edelson JG (1996) Variations in the anatomy of the scapula with reference to the snapping scapula. Clin Orthop Relat Res 322:111–115PubMedCrossRef Edelson JG (1996) Variations in the anatomy of the scapula with reference to the snapping scapula. Clin Orthop Relat Res 322:111–115PubMedCrossRef
6.
go back to reference Graves WW (1910) The scaphoid scapula: a frequent anomaly in development of hereditary, clinical and anatomical significance. Med Rec 78:861–873 Graves WW (1910) The scaphoid scapula: a frequent anomaly in development of hereditary, clinical and anatomical significance. Med Rec 78:861–873
7.
go back to reference Gray DJ (1942) Variations in the human scapulae. Am J Phys Anthropol 29:57–72CrossRef Gray DJ (1942) Variations in the human scapulae. Am J Phys Anthropol 29:57–72CrossRef
8.
go back to reference Hrdlika A (1937) Human typogeny. Proc Am Philos Soc 78:79–95 Hrdlika A (1937) Human typogeny. Proc Am Philos Soc 78:79–95
9.
go back to reference Kuhn JE (2006) The scapulothoracic articulation: anatomy, biomechanics, pathophysiology, and management. In: Iannotti JP, Williams GR (eds) Disorders of the shoulder: diagnosis and management, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 1057–1086 Kuhn JE (2006) The scapulothoracic articulation: anatomy, biomechanics, pathophysiology, and management. In: Iannotti JP, Williams GR (eds) Disorders of the shoulder: diagnosis and management, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 1057–1086
10.
go back to reference Kuhn JE, Plancher KD, Hawkins RJ (1998) Symptomatic scapulothoracic crepitus and bursitis. J Am Acad Orthop Surg 6:267–273PubMed Kuhn JE, Plancher KD, Hawkins RJ (1998) Symptomatic scapulothoracic crepitus and bursitis. J Am Acad Orthop Surg 6:267–273PubMed
11.
go back to reference Kuhne M, Boniquit N, Ghodadra N, Romeo AA, Provencher MT (2009) Current concepts the snapping scapula: diagnosis and treatment. Arthroscopy 25:1298–1311PubMedCrossRef Kuhne M, Boniquit N, Ghodadra N, Romeo AA, Provencher MT (2009) Current concepts the snapping scapula: diagnosis and treatment. Arthroscopy 25:1298–1311PubMedCrossRef
12.
go back to reference Kuhns J (1945) Variations in the vertebral border of the scapula. Their relation to muscular function. Physiother Rev 25:207–210 Kuhns J (1945) Variations in the vertebral border of the scapula. Their relation to muscular function. Physiother Rev 25:207–210
13.
go back to reference Lehtinen J, Tingart M, Apreleva M, Warner J (2005) Quantitative morphology of the scapula: normal variation of the superomedial scapular angle, and superior and inferior pole thickness. Orthopedics 28:481–486PubMed Lehtinen J, Tingart M, Apreleva M, Warner J (2005) Quantitative morphology of the scapula: normal variation of the superomedial scapular angle, and superior and inferior pole thickness. Orthopedics 28:481–486PubMed
14.
go back to reference Lesprit E, Le Huec JC, Moinard M, Schaeverbeke T, Chauveaux D (2001) Snapping scapula syndrome: conservative and surgical treatment. Eur J Orthop Surg Traumatol 11:51–54CrossRef Lesprit E, Le Huec JC, Moinard M, Schaeverbeke T, Chauveaux D (2001) Snapping scapula syndrome: conservative and surgical treatment. Eur J Orthop Surg Traumatol 11:51–54CrossRef
15.
go back to reference Majó J, Gracia I, Doncel A, Valera M, Núñez A, Guix M (2001) Elastofibroma dorsi as a cause of shoulder pain or snapping scapula. Clin Orthop Relat Res 388:200–204PubMedCrossRef Majó J, Gracia I, Doncel A, Valera M, Núñez A, Guix M (2001) Elastofibroma dorsi as a cause of shoulder pain or snapping scapula. Clin Orthop Relat Res 388:200–204PubMedCrossRef
16.
go back to reference Milch H (1950) Partial scapulectomy for snapping of the scapula. J Bone Joint Surg Am 32:561–566PubMed Milch H (1950) Partial scapulectomy for snapping of the scapula. J Bone Joint Surg Am 32:561–566PubMed
17.
go back to reference Mozes G, Bickels J, Ovadia D, Dekel S (1999) The use of three-dimensional computed tomography in evaluating snapping scapula syndrome. Orthopedics 22:1029–1033PubMed Mozes G, Bickels J, Ovadia D, Dekel S (1999) The use of three-dimensional computed tomography in evaluating snapping scapula syndrome. Orthopedics 22:1029–1033PubMed
18.
go back to reference O’Holleran JD, Millett PJ, Warner JJP (2004) Arthroscopic management of scapulothoracic disorders. In: Miller MD, Cole BD (eds) Textbook of arthroscopy, 3rd edn. Saunders, Philadelphia, pp 277–287CrossRef O’Holleran JD, Millett PJ, Warner JJP (2004) Arthroscopic management of scapulothoracic disorders. In: Miller MD, Cole BD (eds) Textbook of arthroscopy, 3rd edn. Saunders, Philadelphia, pp 277–287CrossRef
19.
go back to reference Oizumi N, Suenaga N, Minami A (2004) Snapping scapula caused by abnormal angulation of the superior angle of the scapula. J Shoulder Elbow Surg 13:115–118PubMedCrossRef Oizumi N, Suenaga N, Minami A (2004) Snapping scapula caused by abnormal angulation of the superior angle of the scapula. J Shoulder Elbow Surg 13:115–118PubMedCrossRef
20.
go back to reference Pavlik A, Ang K, Coghlan J, Bell S (2003) Arthroscopic treatment of painful snapping of the scapula by using a new superior portal. Arthroscopy 19:608–612PubMedCrossRef Pavlik A, Ang K, Coghlan J, Bell S (2003) Arthroscopic treatment of painful snapping of the scapula by using a new superior portal. Arthroscopy 19:608–612PubMedCrossRef
21.
go back to reference Pearse EO, Bruguera J, Massoud SN, Sforza G, Copeland SA, Levy O (2006) Arthroscopic management of the painful snapping scapula. Arthroscopy 22:755–761PubMedCrossRef Pearse EO, Bruguera J, Massoud SN, Sforza G, Copeland SA, Levy O (2006) Arthroscopic management of the painful snapping scapula. Arthroscopy 22:755–761PubMedCrossRef
22.
go back to reference Percy EC, Birbrager D, Pitt MJ (1988) Snapping scapula: a review of the literature and presentation of 14 patients. Can J Surg 31:248–250PubMed Percy EC, Birbrager D, Pitt MJ (1988) Snapping scapula: a review of the literature and presentation of 14 patients. Can J Surg 31:248–250PubMed
23.
go back to reference Ruland LJ III, Ruland CM, Matthews LS (1995) Scapulothoracic anatomy for the arthroscopist. Arthroscopy 11:52–56PubMedCrossRef Ruland LJ III, Ruland CM, Matthews LS (1995) Scapulothoracic anatomy for the arthroscopist. Arthroscopy 11:52–56PubMedCrossRef
24.
go back to reference Safran MR (1997) Management of scapulothoracic problems. Curr Opin Orthop 8:67–74CrossRef Safran MR (1997) Management of scapulothoracic problems. Curr Opin Orthop 8:67–74CrossRef
25.
go back to reference Takahara K, Uchiyama S, Nakagawa H, Kamimura M, Ohashi M, Miyasaka T (2004) Snapping scapula syndrome due to malunion of rib fractures: a case report. J Shoulder Elbow Surg 13:95–98PubMedCrossRef Takahara K, Uchiyama S, Nakagawa H, Kamimura M, Ohashi M, Miyasaka T (2004) Snapping scapula syndrome due to malunion of rib fractures: a case report. J Shoulder Elbow Surg 13:95–98PubMedCrossRef
Metadata
Title
Bony structures related to snapping scapula: correlation to gender, side and age
Authors
Trifon Totlis
George A. Konstantinidis
Marinos T. Karanassos
George Sofidis
Nikolaos Anastasopoulos
Konstantinos Natsis
Publication date
01-01-2014
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 1/2014
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-013-1130-4

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