Sven Freche, Franziska Juch, Thomas Nusselt, Karl-Stefan Delank, Alexander Hagel

Bilateral snapping skapula sendromunun artroskopik tedavisi: Olgu sunumu ve literatürün incelenmesi

Snapping skapula sendromu, omuz cerrahisinde ender görülen bir durumdur. Klinik olarak, omuz hareketi sırasında omuz ağrısı ve yüksek krepitus olarak kendini gösterir. Bunun dışında, glenohu¬meral bursit ilave bir ağrıya yol açabilir. Snapping skapula sendromu, skapulanın superomedial bölü¬münde artan açılanmanın bursit ile birleşmesi sonucu ortaya çıkar. Subskapular osteokondrom ya da kaburga kırıklarının kaynamaması gibi sık görülen nedenler ise değerlendirme dışı bırakılmıştır. Bu çalışmamızda, sol omuzunu hareket ettirdiğinde sürekli omuz ağrısı ile birlikte rahatsız edici derecede krepitusu olan 24 yaşındaki bir kadın hasta sunuyoruz. Hastanın radyolojik muayeneleri ile her iki ta¬rafta skapulanın superomedialinde açılanma ve MRG ile sol omuzdaki bursit teyit edildi. Hastanın sol skapuladaki yerleşik kemik oluşumu minimal invaziv artroskopik düzeltme ve bursektomi ile başarılı bir şekilde tedavi edildi. Hastanın her iki omuzu için, ayrıca, belli ağrı azaltıcı fizyoterapi egzersizleri uygulandı. Altı ay sonraki takip muayenesinde hastanın her iki omuzunu krepitus olmaksızın ağrısız bir şekilde hareket ettirebildiği görüldü.

Anahtar Kelimeler:

Çatırdama; omuz; snapping skapula sendromu; superomedial skapula.

Arthroscopic treatment of bilateral snapping scapula syndrome: a case report and review of the literature

Snapping scapula syndrome represents a rare entity in shoulder surgery. Clinically, it presents as shoulder pain and loud crepitus during shoulder movement. Moreover, glenohumeral bursitis can cause additional pain. Snapping scapula syndrome is caused by an increased angulation of the superomedial part of the scapula combined with bursitis. Other common causes such as subscapular osteochondroma or rib fracture non-unions were excluded. We report a 24-year-old female patient with persisting shoulder pain and disturbing crepitus during movement of the left shoulder. Radiographic examination revealed increased angulation of the superomedial scapula on both sides and MRI, bursitis of the left shoulder. The patient was successfully treated with minimally invasive arthroscopic trimming of the prominent osseous formation at the left scapula combined with bursectomy. Additionally, specific pain-adapted physiotherapeutic exercises of both shoulders were performed. The patient had a painfree shoulder movement without crepitus on both sides at the 6th month follow-up.

Keywords:

Cracking, shoulder, snapping scapula syndrome superomedial scapula,

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