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Surgical Solution to Snapping Scapula

Posted on: 11/30/1999
You've heard of a snapping turtle, but what about a snapping scapula? The scapula is your shoulder blade. Normally, this bone glides smoothly across the chest wall. But fractures, tumors, trauma, and muscle weakness can put an end to this smooth motion. Painful snapping that is both felt and heard can be the result. This snapping is called crepitus. It is not always clear what causes snapping scapula.

Snapping scapula is treated with steroid injections or exercise. But some patients have surgery to shave bone from the underside of the scapula. The idea is to make the surface smooth so it doesn't bump along during shoulder movement. Only one corner of the scapula is thinned this way. Doctors use an arthroscope to do the operation. An arthroscope is a tiny fiber-optic TV camera that is inserted into the space between the scapula and the chest wall. It alows the doctor to see and work on the problem area. In this study, doctors tried a very new way to insert the arthroscope. The opening avoids nerves and blood vessels while still giving doctors a good view inside.

The authors report zero technical problems with this new method. No damage occurred to the nerves or blood vessels. All patients got pain relief, and all but one went back to work. The crepitus was better, although only two of the 10 patients had complete relief from the snapping.

References:
Attila Pavlik, MD, et al. Arthroscopic Treatment of Painful Snapping of the Scapula by Using a New Superior Portal. In Arthroscopy. July-August, 2003. Vol. 19. No. 6. Pp. 608-612.

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