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Scapulothoracic Arthroscopy

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Shoulder Arthroscopy

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Abstract

Scapulothoracic arthroscopy was developed to manage periscapular pain frequently associated with crepitus or popping. The condition is also known as “snapping scapula syndrome.” It is typically located at the superomedial angle of scapula although some other areas can be involved as well. Bursitis of the scapulothoracic articulation is usually suspected. Underlying cause like soft tissue lesion or bony abnormality is rarely identified. The pathomechanics probably involves a combination of increased bony prominence and a loss of normal dynamic scapular control resulting in compressing the bursa between scapula and thoracic wall. Understanding the periscapular anatomy is important for making the diagnosis and to conduct the surgical therapy in safe manner. Initial treatment is nonoperative, if no obvious anatomic cause is present. Activity modification, physical therapy, anti-inflammatory medications, and local injections are frequently successful. Persisting pain and shoulder dysfunction despite these measures are indications for surgical treatment. Arthroscopic bursectomy with partial scapulectomy, i.e., superomedial angle resection is currently the most beneficial method of treatment. Still, some patients report residual symptoms after surgical procedure. Therefore, appropriate patient selection, education, and discussion on expectations prior surgical treatment are necessary.

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Authors and Affiliations

  1. Arbor Mea Medical - Artro Center, Ljubljana, Slovenia

    Ladislav Kovačič

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  1. Ladislav Kovačič
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Editors and Affiliations

  1. Department of Joint and Bone Surgery, University of Brescia, Brescia, Brescia, Italy

    Giuseppe Milano

  2. Department of Orthopaedics and Traumatology, Casa di Cura Villa Valeria, Rome, Roma, Italy

    Andrea Grasso

  3. Shoulder and Upper Limb Department, St. Luke's Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  4. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

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Kovačič, L. (2023). Scapulothoracic Arthroscopy. In: Milano, G., Grasso, A., Brzóska, R., Kovačič, L. (eds) Shoulder Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-66868-9_32

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  • DOI: https://doi.org/10.1007/978-3-662-66868-9_32

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