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Saturday, March 18, 2000

Snapping scapula syndrome responds favorably to nonoperative treatments

Snapping scapula syndrome is an uncommon source of shoulder pain in athletes and most patients respond favorably to nonoperative treatment, said Marc D. Silver, MD, assistant professor, department of orthopaedics and rehabilitation, section of sports medicine, Yale University School of Medicine, who presented scientific exhibit 264.

"Occasionally, open surgical management may become necessary for resistant cases," Dr. Silver observed. "Recently, there have been reports of arthroscopic treatment for this condition."

The scientific exhibit reports on arthroscopic treatment of four patients for snapping scapula syndrome. All had failed conservative management. The operative technique involved general anesthesia with patient placed in the prone position. Arthroscopic visualization of the scapular was performed through two portals placed approximately 2 cm medial to the medial border of the scapula below the scapular spine.

"Upon arthroscopic visualization, there was a bursa located over the superior medial angle of the scapula, which was debrided," said Dr. Silver. "Occasionally, a bony prominence was noted beneath the bursa and subsequently resected." All patients were discharged from the hospital within 24 hours of the procedure. On average, one year follow-up, patients in the series remained asymptomatic.

"Arthroscopic treatment for snapping scapula syndrome seems to be a promising alternative to open surgical resection of the superior medial border of the scapula, Dr. Silver said. "The advantages of the procedure over open resection include decreased morbidity, decreased hospital stay, accelerated rehabilitation and improved cosmesis."

Co-author of the study is John P. Daigneault, MD, assistant professor, department of orthopaedics and rehabilitation, section of sports medicine, Yale University School of Medicine.

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2000 Academy News March 18 Index C

Last modified 24/February/2000 by IS