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肩胛胸壁滑囊切除术

PDF Evidence Consent
Updated Oct 2026
Illustration: shoulder

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

为何建议进行此手术

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 医生会从适合您病情的最微创方案入手。患者通常由全科医生转诊至我们的诊所；如果物理治疗师建议您就诊，您仍需获得全科医生的转诊，才有资格享受 Medicare 报销。门诊评估包括采集您的病史、体格检查以及在需要时进行的影像学检查，以明确诊断。

弹响肩胛综合征是指肩胛骨在肋骨上方活动时出现摩擦或咔哒作响。它通常由发炎的滑囊引起。滑囊是肩胛骨与肋骨之间一层薄薄的组织衬垫，有时还伴有肩胛骨内上角的骨性突起。大多数人无需手术即可好转，方法包括物理治疗、抗炎药物、改变活动方式以及在影像引导下向滑囊内注射，通常会尝试数个月。当这些治疗未能给您带来足够改善时，我们会建议进行这项手术。手术会切除肩胛骨与肋骨之间空隙内发炎的滑囊，如果发现肩胛骨的角突出，也会将其修整。手术的目的是缓解您的疼痛，并改善您肩部的功能。

术前

到这个阶段，您通常已经做过用于规划手术的扫描，例如X光、超声或磁共振成像（MRI）；磁共振成像能详细显示肩胛骨周围的软组织。您的外科医生会就手术当天的安排给您明确的指示。手术前七小时内请勿进食或饮水，以便如果手术排程提前，您的手术时间可以提前。请携带一份您目前服用药物的清单，并告诉我们您定期服用的任何药物，因为有些药物可能需要在术前暂停。请安排他人在术后驾车送您回家。请穿着宽松、舒适且易于穿脱的衣物。如果您有其他健康状况，可能需要进行血液检查或接受麻醉医生的评估。

手术当日

您将抵达医院的手术入院单元，在此办理入院手续并进行术前准备。随后，您将与麻醉医生见面，麻醉医生是在手术期间负责您的麻醉和舒适的医生。这项手术在全身麻醉下进行，因此您会完全处于睡眠状态。手术结束时，会将局部麻醉药注射到小伤口以及肩胛骨下方的空隙内，以减轻您苏醒时的疼痛。这项手术通常不需要另外进行神经阻滞。麻醉医生会在术前与您见面，并向您详细说明。

随后，您将被带入手术室进行手术。手术结束后，您将在复苏区苏醒。护士会一直陪在您身边，在麻醉作用消退期间监测您的情况。待您的状况平稳后，根据手术情况和您的恢复情况，您将被转入病房或直接回家。

手术内容

这是一项微创（锁孔）手术。手术时您通常取俯卧位（脸朝下趴着），外科医生会沿肩胛骨内侧缘（最靠近脊柱的一侧）做几个小切口。一个细小的摄像头经其中一个切口进入肩胛骨与肋骨之间的空隙。手术在这个空隙内进行，而不是在肩关节内部。

外科医生通过其他小切口切除发炎的滑囊，也就是位于肩胛骨与肋骨之间的那层薄薄的组织衬垫。清除这些组织后，可以清楚地看到该区域。如果肩胛骨的内上角看起来突出，也会将该角的一部分修整掉。是否需要这样做，是在手术中根据外科医生的发现而决定的。

手术结束时，小切口用缝线闭合。伤口内已经注入了局部麻醉药，以减轻您苏醒时的疼痛。

术后

大多数患者在此手术后需在医院过夜一晚，但部分患者可于当日出院。您将在复苏区苏醒，随后转入病房。您的手臂将佩戴简易吊带以提供舒适支撑；进行锻炼和清洗时需取下吊带。护士会检查您的疼痛情况，并给您用药以保持舒适。在最初一两天内，背部和胸部侧面出现一些肿胀很常见。肿胀会自行消退。您回家后的最初24小时内，请安排有人陪伴您。我们通常会保留敷料约10天；除非我们告知您，否则请勿提前拆除。我们将在复诊时为您更换或拆除敷料。

恢复

最初几天，您的肩部及其周围区域会感到酸痛和肿胀。术中注入的局部麻醉药会在数小时内失效，因此请在药效消退之前服用我们给您的止痛药。休息、用毛巾包裹的冰袋以及保持手部活动都有助于减轻不适。背部和胸部的肿胀会自行消退。

您回家时手臂将佩戴简易吊带以提供舒适支撑。进行锻炼和清洗时需取下吊带。起初，物理治疗师会指导您进行轻柔的活动，随着酸痛缓解，再逐步过渡到力量训练。请保持敷料干燥，在复诊之前不要动它。

日常活动会分阶段恢复。一旦您感觉稳定，就可以用手进行轻松的活动，例如吃饭、打字和泡一杯茶。提举重物、将手臂伸过头顶以及较重的家务，要等到您的外科医生认为愈合已经足够充分之后才能进行。一旦您不再需要佩戴吊带、感觉舒适，并且能够转动方向盘和回头查看而不感到疼痛，就可以重新驾驶。更多详情请参阅我们关于上肢手术后的驾驶的页面。

大多数人发现，随着疼痛改善，咔哒声或摩擦声也会减轻，但即使肩部感觉好多了，有些声响仍可能存在。每个人的恢复情况各不相同。您的外科医生和物理治疗师会指导您的恢复进度。

可能出现的问题

大多数患者恢复良好，但偶尔可能出现一些问题。您的外科医生和医疗团队会密切监测您的状况，以便尽早发现任何问题。

有时发炎的组织没有被完全清除，或残留了一块粗糙的骨面。如果出现这种情况，在恢复期过后，卡住或摩擦的感觉可能会持续存在。如果声响或不适没有像我们讨论过的那样消退，请在下次复查时提出。届时可以考虑进一步治疗。

有些人即使在伤口愈合后，仍会注意到肩胛骨活动异常。您可能会感到肩胛骨从背部向外翘起，或在伸手时卡住。如果这种情况持续存在并限制了您的活动，请在复查时告诉我们，以便我们进行评估。

少数人在术后仍有症状，例如疼痛或咔哒声未能完全消失。您的肩部也可能不如您期望的那样有力或舒适。如果您觉得恢复比预期慢，请向我们提出。我们会检查您的肩部，并与您讨论还有哪些方法可以采用。

如果您出现发热、伤口周围发红范围向外扩散，或伤口有液体或脓液渗出，请在当天致电诊所。如果尽管服用了止痛药，疼痛仍在持续加重，也请在当天致电。如果您注意到新出现的麻木，或无法活动手臂、手或手指，请致电诊所。

如果您想了解具体数据，本页面中的并发症表格列出了典型发生率。

何时联系我们

大多数问题会在最初几周内出现。如果您的小腿肿胀或疼痛，或出现呼吸急促或胸痛，请前往急诊科。这些可能是血凝块的征兆。如果您的手或手指变得苍白、冰冷、发白、发青或发黑，也请前往急诊科。

如果您出现发热、伤口周围发红范围向外扩散，或伤口有液体或脓液渗出，请在当天致电诊所。如果尽管服用了止痛药，疼痛仍在持续加重，也请在当天致电。如果您注意到新出现的麻木，或无法活动手臂、手或手指，请致电诊所。

如果您无法联系到我们，例如在非工作时间或周末，请前往离您最近的急诊科。

Reviewed by AI synthesis (v2) — pending human review · 4 October 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis [1].
  • Snapping scapula syndrome can be difficult to recognize and treat [1].
  • The best initial approach to scapulothoracic bursitis and crepitus is a nonoperative treatment plan that combines scapular strengthening, postural reeducation, and core strength endurance [6].
  • Nonoperative management is advised for 3 to 6 months before operative treatment [2].
  • Nonoperative management is as effective as surgical management in pain relief [2].
  • Open surgical treatment for snapping scapula provides durable pain relief [5].
  • Nonsurgical treatment for snapping scapula provides durable pain relief [5].
  • Surgically treated patients improved faster than nonsurgically treated patients [5].
  • It cannot be concluded that surgery is better than nonsurgical treatment for snapping scapula [5].
  • Arthroscopic scapulothoracic treatment provides good pain relief for scapulothoracic syndrome in patients who have failed to respond to nonoperative treatment modalities [3].
  • Arthroscopic scapulothoracic treatment provides functional improvement for scapulothoracic syndrome in patients who have failed to respond to nonoperative treatment modalities [3].
  • Arthroscopic bursoscopy and bursectomy is an effective surgical procedure in recalcitrant scapulothoracic bursitis with failed conservative management [4].
  • Extracorporeal shock wave therapy (ESWT) is a beneficial and trustable method of treatment for painful cases of scapulothoracic bursitis [7].

Anatomy & Pathophysiology

Scapulothoracic Articulation & Biomechanics

  • The scapula is separated from the chest wall by thin gliding fibro-fatty tissue, allowing its smooth excursion over the chest wall [12].
  • Normal shoulder motion is approximately two-thirds glenohumeral and one-third scapulothoracic [13].
  • The scapulothoracic articulation is one of four articulations that work together to allow smooth shoulder function [23].
  • The scapula is suspended by muscles alone and has shifted caudally from the cervical position in lower animals [20].
  • Broadening of the infraspinatus fossa has resulted in a change in the vector of muscle pull from the axillary border of the scapula to the glenoid fossa [20].
  • This adaptation allows the infraspinatus and teres minor muscles to be more effective in their roles as depressors and external rotators of the humeral head [20].
  • The scapula is anteverted on the chest wall approximately 30 degrees relative to the body [24].

Bony Anatomy

  • The scapula is triangular when viewed anteroposteriorly, with its base situated superiorly and its apex inferiorly [12].
  • The glenoid is connected with the flat body of the scapula by the scapular neck [12].
  • The hook-shaped coracoid process curves forwards from the superior surface of the scapular neck [12].
  • The scapular spine ends in a flattened bony process, the acromion, which curves forwards [12].
  • The highest concentration of bony mass in the scapula is located in the glenoid, the scapular neck (including the base of the coracoid process), and the lateral border of the scapular body [12].
  • The lateral pillar connects the inferior border of the glenoid with the inferior angle [12].
  • The spinal pillar arises from the central part of the glenoid and continues medially to become part of the base of the scapular spine [12].
  • The weakest bone in the scapula is located primarily in the central part of the biomechanical body, i.e., in the infraspinous fossa [12].
  • The weakest area of the circumference of the biomechanical body of the scapula is the spinomedial angle [12].
  • The glenoid is a convex structure of shallow depth shaped like an inverted pear [10].
  • The glenoid averages 5° of retroversion in relation to the axis of the scapular body [13].
  • The subchondral bone of the glenoid is relatively flat, and the articular concavity is augmented by cartilage and a circumferential labrum [13].
  • The acromion has three ossification centers: the metacromion (base), the mesoacromion (middle), and the preacromion (tip) [13].
  • Failure of fusion of the acromial ossification centers results in os acromiale [13].
  • The scapular spine is an osseous ridge that separates the supraspinatus and infraspinatus fossae [13].

Soft Tissue & Bursae

  • The subscapular bursa lies between the subscapularis tendon and the neck of the scapula [14].
  • The subscapular bursa communicates with the joint cavity between the superior and middle glenohumeral ligaments [14].
  • The subscapular bursa protects the tendon of the subscapularis at the point where it passes under the base of the coracoid process and over the neck of the scapula [14].
  • The subscapular bursa is linked to the coracoid process by a suspensory ligament [14].
  • In 28% of specimens dissected by Colas and colleagues, the subscapular bursae merged with the subcoracoid bursae, forming a unique wide bursa in this region [14].
  • The subscapular bursa often houses loose bodies in the shoulder [14].
  • The subscapular bursa is a region in which synovitis of the shoulder may be most intense [14].
  • Small fringes, or villi, can project into the joint cavity from the subscapular bursa [14].
  • The rotator cuff is a sheet of conjoined tendons closely applied over the shoulder capsule and inserting mainly into the greater tuberosity of the humerus [18].
  • The subscapularis is inserted into the lesser tuberosity [18].
  • The coracoacromial arch is formed by the acromion process posterosuperiorly, the coracoid process anteriorly, and the coracoacromial ligament joining them [18].
  • The subacromial bursa separates the rotator cuff tendons from the coracoacromial arch, allowing them to glide [18].

Pathophysiology

Investigations

Imaging Principles and General Approach

  • The purpose of shoulder imaging is to help establish the diagnosis, determine the severity of the pathoanatomy, assist in surgical planning, and enable the surgeon to illustrate the condition of the shoulder to the patient [8].
  • Unless a specific research protocol is in place, the temptation to “overimage” should be resisted, obtaining only the scans or reconstructions that are necessary for the care of the patient [8].
  • Standardized plain films are almost always sufficient to garner the information needed for shoulder evaluation [8].
  • Proper radiographic technique is as important as proper surgical technique to achieve the desired outcome [8].
  • The shoulder is a three-dimensional structure that cannot be represented by a single planar view [30].
  • Critical relationships, such as the degree of centering of the humeral head, change with the position of the arm [30].
  • Shoulder pathology may be found in a large number of different bones and soft tissues [30].
  • Overlying and superimposed structures as well as metallic implants may complicate imaging the structures of interest [30].
  • Surgeons need to develop a judicious approach to imaging that yields the information necessary to treat the patient while avoiding the tendency to "over-image" [30].

Plain Radiography

  • At least two X-ray views should be obtained for shoulder evaluation: an anteroposterior in the plane of the glenoid and an axillary projection with the arm in abduction to show the relationship of the humeral head to the glenoid [27].
  • The first key view is the anteroposterior (AP) in the plane of the scapula taken so that the x-ray beam passes through the glenohumeral joint [8].
  • The AP view in the plane of the scapula shows the superoinferior position of the humeral head relative to the glenoid, the presence of osteophytes on the humeral head and glenoid, narrowing of the joint space, and the degree of medial displacement of the humerus in relation to the lateral acromial line [8].
  • The AP view in the plane of the scapula also shows the quality of the humeral and glenoid bone, the presence of loose bodies, and whether there is humeral head collapse or deformity [8].
  • The second key view is the axillary view taken with the arm in the functional position of elevation in the plane of the scapula and oriented so that both the spinoglenoid notch and the scapular neck are visible [8].
  • The axillary view shows a different perspective of the humeral anatomy, the amount of glenoid bone, the shape of the glenoid, its version in relation to the plane of the scapula, and the relationship of the humeral head to the glenoid fossa [8].
  • The standardized axillary view is referred to as the “truth view” because it demonstrates the glenohumeral relationships in the functional position of elevation [8].
  • CT scans have the disadvantage of being taken with the arm in the adducted position, whereas the axillary truth view is taken with the arm in elevation [8].
  • When taken properly, standardized anteroposterior and axillary views indicate the thickness of the cartilage space between the humerus and the glenoid, relative positions of the humeral head and the glenoid, presence of osteophytes, degree of osteopenia, and extent of bony deformity and erosion [8].
  • Joint space narrowing is most evident on the axillary truth view as opposed to images made with the arm at the side [8].
  • The axillary truth view can show posterior subluxation or “functional decentering” that is not evident in images taken with the arm at the side [8].
  • The degree of posterior subluxation can be measured as the position of the center of the humeral head in relation to the plane of the scapula, the position of the center of the humeral head in relation to the glenoid face, or the point of contact of the humeral articular surface on the glenoid articular surface [8].
  • The point of contact of the humeral articular surface on the glenoid articular surface reflects the degree of centering of the net humeral joint reaction force on the glenoid [8].
  • Malcentering of the joint reaction force leads to posterior instability, posterior glenoid wear, and “rocking horse” loosening of prosthetic glenoid components [8].
  • The standard shoulder series should include orthogonal views of the shoulder, including a true AP view in the scapular plane, an AP view, an axillary view, and a scapular Y view [35].
  • The true AP view in the scapular plane visualizes the anterior greater tuberosity in profile and can reveal proximal humeral migration [35].
  • The AP view with the arm in internal rotation visualizes the posterior aspect of the greater tuberosity and the lesser tuberosity in profile [35].
  • The axillary view is necessary for evaluation of glenohumeral joint instability and enables determination of the humeral head position in the glenoid fossa [35].
  • The axillary view may detect occult, locked posterior shoulder dislocation in a patient who exhibits a lack of passive external rotation [35].
  • The axillary view is helpful in evaluation of glenoid morphology in glenohumeral osteoarthritis and provides good visualization of the coracoid process, acromion, and distal clavicle [35].
  • The scapular Y view provides visualization of the coracoacromial arch and can reveal coracoacromial spurs [35].
  • The scapular Y view is a reliable alternative for evaluation of glenohumeral subluxation and dislocation [35].
  • The scapular Y view can show scapular body abnormalities, such as osteochondroma or fracture, and acromial shape [35].
  • The acromiohumeral distance is normally 7 to 14 mm [35].
  • The width of the glenohumeral joint space should be symmetric superiorly and inferiorly [35].
  • The coracoclavicular distance is normally 1.1 to 1.3 cm [35].
  • Neer classified acromial morphology as type I (flat), type II (curved), and type III (hooked) [35].
  • Type III acromial morphology has been shown to have a correlation with the presence of rotator cuff disease, although no direct causal relationship has been demonstrated [35].
  • The Neer classification of acromial morphology has shown relatively poor interobserver reliability [35].
  • Arthritis, calcific tendinitis, and osteolysis of the distal clavicle can be observed on plain radiograph [34].

Computed Tomography (CT)

  • CT scans may offer a few degrees of increased precision in the measurement of glenoid version [8].
  • There is no conviction that increased precision in glenoid version measurement via CT improves the quality of the surgery or the clinical outcome [8].
  • There is information that can be gathered from properly taken plain films that cannot be obtained from CT scans [8].
  • Three-dimensional reconstructions can reveal fine details of the shoulder anatomy, but this additional information rarely changes the planning or conduct of the arthroplasty [8].
  • CT imaging is frequently used to evaluate fractures of the shoulder, to assess for bony lesions in recurrent instability cases, or for preoperative templating for shoulder arthritis [34].
  • CT with three-dimensional reconstructions is the advanced imaging study of choice for determining the extent of glenoid bone loss in the setting of shoulder instability [35].
  • CT is helpful for planning fracture surgery and shoulder joint replacement [27].

Magnetic Resonance Imaging (MRI)

  • MRI is useful to identify osteonecrosis of the humeral head, or a bone tumour [27].
  • MRI can identify labral tears and rotator cuff tears, although the accuracy for these is enhanced by combining the scan with arthrography [27].
  • MRI is the modality of choice for evaluating the rotator cuff, biceps, and subacromial/subdeltoid bursa [34].
  • T1-weighted MRI can reveal Hill-Sachs lesions and is often used with magnetic resonance (MR) arthrograms to provide a more detailed picture of the joint surfaces [34].
  • T2-weighted MRI provides better visualization of full thickness rotator cuff tears [34].
  • Traditional magnetic resonance imaging (MRI) is a diagnostic tool to complement both physical examination and standard radiographs in the management of patients with anterior shoulder instability [32].
  • MRI is utilized for evaluation of soft tissues, which can be performed with high contrast and spatial resolution [32].
  • MR accuracy in identifying labral and rotator cuff tears in the literature ranges from 70% to 100% [32].
  • The acquired multi-planar imaging allows for the detailed evaluation of the glenoid, labrum, joint capsule, and rotator cuff in different planes [32].
  • Abduction and external rotation (ABER) of the arm is an alternative position utilized to increase the sensitivity and specificity for detecting anteroinferior labroligamentous injury [32].
  • Limited range of motion or pain may prohibit patients from performing the ABER provocative maneuver [32].
  • Full routine MRI or MRA examination had similar accuracy as the ABER sequence in evaluating the anteroinferior labral–ligamentous complex [32].
  • The sensitivity of MRA with the ABER position for detecting anteroinferior labral lesions was significantly higher than that of the MRA in neutral position [32].
  • MRA with the ABER position is more effective in identifying Perthes lesions than MRA in neutral position [32].
  • MRAs can demonstrate a patulous capsule on the coronal, sagittal, and axial imaging in patients with multidirectional instability [32].
  • MRAs can be helpful in evaluating lesions of the rotator interval and other associated findings that may affect the eventual surgical plan [32].
  • The presence of glenoid dysplasia, increased capsular cross-sectional area, and increased glenoid retroversion have all been found to be associated with increased posterior labral tears and symptomatic instability [32].
  • Glenoid retroversion was significantly increased in patients with symptomatic posterior labral tears [32].
  • There was no significant association between instability and increased humeral head subluxation in patients with symptomatic posterior labral tears [32].
  • The diagnosis of multidirectional instability is a clinical one, and the need for expensive and/or invasive imaging should be weighed against the information that will be gained from these studies [32].

Arthrography

  • Arthrography involves injection of contrast agent in conjunction with either an MRI or CT scan, enhancing imaging of the joint to enable better identification of normal structures and pathology involving the joint surfaces [34].
  • MR arthrography is considered the benchmark for evaluation for labral tears and rarely is indicated for evaluation of rotator cuff pathology [34].
  • When MRI or MR arthrography is contraindicated, such as in patients with a pacemaker or vascular clips, CT arthrography is indicated [34].
  • Magnetic resonance (MR) arthrography refers to MRI of a joint that has been injected with an intra-articular contrast agent such as diluted gadolinium or saline solution [32].
  • The contrast material is injected prior to MRI by fluoroscopic or ultrasound guidance under strict aseptic technique [32].
  • By distending the joint capsule, the cartilage, ligaments, and labrum are outlined with contrast, increasing the sensitivity for detecting tears and other lesions [32].
  • In the acute dislocation setting, a joint effusion with distension of the joint may outline structures similarly, making the arthrogram unnecessary [32].
  • MR arthrography has proven utility by increasing both sensitivity and specificity in detecting injuries to the capsulolabral–ligamentous complex as compared to traditional MRI [32].
  • In a meta-analysis of 6 studies including 4,667 shoulders, MRA had greater diagnostic test accuracy for the detection of glenoid labral lesions than MRI [32].
  • MRA sensitivity for glenoid labral lesions was 88% and specificity was 93% [32].
  • MRI sensitivity for glenoid labral lesions was 76% and specificity was 87% [32].

Ultrasonography

  • Ultrasonography is a simple and accurate test for identifying rotator cuff tears and calcific tendinitis [27].
  • Ultrasonography can be useful in guiding injections or barbotage, such as aspirating calcific deposits in the rotator cuff [27].
  • Ultrasonography is a low-cost alternative to MRI and arthrography for evaluating both skeletal and soft-tissue structures of the shoulder [34].
  • Ultrasonography can provide immediate, real-time visualization of the rotator cuff, biceps tendon, and calcific deposits [34].
  • Ultrasonography can be used to measure the subacromial space and detect atrophy of rotator cuff muscles [34].
  • As a result of providing images in real-time, ultrasonography can evaluate impingement in various positions and motions [34].
  • Ultrasonography is highly operator dependent [34].
  • Ultrasonography is not as useful for evaluating labral tears or rotator cuff tears that are very small or larger than 3 cm [34].
  • The most commonly performed joint examination using ultrasonography is the shoulder examination [25].
  • Accuracy of shoulder ultrasonography depends on the skill of the scanner operator and an awareness of pitfalls that are encountered [25].

Treatment

Non-Operative

  • Extracorporeal shock wave therapy (ESWT) is a beneficial and trustable method of treatment that can be strongly recommended in painful cases of scapulothoracic bursitis [7].
  • Patients treated nonsurgically for snapping scapula did so well, although surgically treated patients improved faster [5].

Operative

  • Arthroscopic scapulothoracic treatment provides good pain relief and functional improvement for scapulothoracic syndrome in patients who have failed to respond to nonoperative treatment modalities [3].

Complications

  • The snapping scapula syndrome can be difficult to recognize and treat [1].

Recovery

Non-Operative Management

  • Patients treated nonsurgically did so well [5].

Operative Management

Comparative Outcomes

Key Evidence

  • [L5] The snapping scapula syndrome is caused by either osseous lesions or scapulothoracic bursitis and can be difficult to recognize and treat. [1] (10.1155/2013/635628)
  • [L4] Nonoperative management is as effective as surgical management in pain relief and is advised for 3 to 6 months before operative treatment. [2] (10.1177/19417381211029211)
  • [L4] Based on the results, the study concludes that arthroscopic scapulothoracic treatment provides good pain relief and functional improvement for scapulothoracic syndrome in patients who have failed to respond to nonoperative treatment modalities. [3] (10.2174/1874325001711010785)
  • [L4] Arthroscopic bursoscopy and bursectomy is an effective surgical procedure in recalcitrant scapulothoracic bursitis with failed conservative management. [4] (10.13107/jocr.2025.v15.i02.5290)
  • [L3] Since the decision to treat these patients surgically was somewhat subjective, and since patients treated nonsurgically did so well (although the surgically treated patients improved faster), we cannot conclude that surgery is better than nonsurgical treatment. [5] (10.1007/s11999-015-4614-1)
  • [L5] The best initial approach to scapulothoracic bursitis and crepitus is a nonoperative treatment plan that combines scapular strengthening, postural reeducation, and core strength endurance. [6] (10.1177/1941738109338359)
  • [L1] We believe that ESWT is a beneficial and trustable method of treatment and can be strongly recommended in painful cases of scapulothoracic bursitis. [7] (10.1177/2309499016684723)

References

[1] Scapulothoracic Anatomy and Snapping Scapula Syndrome. Anatomy Research International. 2013. DOI: 10.1155/2013/635628

[2] Diagnosis and Treatment of Snapping Scapula Syndrome: A Scoping Review. Sports Health: A Multidisciplinary Approach. 2021. DOI: 10.1177/19417381211029211

[3] Outcome of Scapulothoracic Arthroscopy for Painful Snapping Scapula. The Open Orthopaedics Journal. 2017. DOI: 10.2174/1874325001711010785

[4] Arthroscopic Management of Snapping Scapular Syndrome due to Recalcitrant Scapulothoracic Bursitis – A Case Series. Journal of Orthopaedic Case Reports. 2025. DOI: 10.13107/jocr.2025.v15.i02.5290

[5] Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment. Clinical Orthopaedics & Related Research. 2016. DOI: 10.1007/s11999-015-4614-1

[6] Clinical Management of Scapulothoracic Bursitis and the Snapping Scapula. Sports Health: A Multidisciplinary Approach. 2010. DOI: 10.1177/1941738109338359

[7] The effectiveness of extracorporeal shock wave therapy in snapping scapula. Journal of Orthopaedic Surgery. 2017. DOI: 10.1177/2309499016684723

[8] Rockwood And Matsen S The Shoulder. Arthroscopic Management of Prearthritic and Arthritic Conditions of the Shoulder and the Postarthroplasty Shoulder > SUMMARY.

[10] Rockwood And Matsen S The Shoulder. Shoulder and Elbow Specialty Clinic Workers’ Survey > ANATOMY.

[12] Rockwood And Green S Fractures In Adults. 29: Principles of Nonunion and Bone Defect Treatment > Applied Anatomy Related to Scapular Fractures.

[13] Aaos Comprehensive Orthopaedic Review 3. Anatomy of the Shoulder, Arm, and Elbow > I. Shoulder.

[14] Rockwood And Matsen S The Shoulder. Developmental Anatomy of the Shoulder and Anatomy of the Glenohumeral Joint > Bursae.

[18] Apley And Solomon S Concise System Of Orthopaedics And Trauma. DISORDERS OF THE ROTATOR CUFF.

[20] Rockwood And Matsen S The Shoulder. Developmental Anatomy of the Shoulder and Anatomy of the Glenohumeral Joint > Development of Individual Regions.

[23] Campbell S Operative Orthopaedics 4 Volume Set. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE-PATELLAR TENDON-BONE GRAFT > SHOULDER INJURIES > ANATOMY AND BIOMECHANICS.

[24] Miller S Review Of Orthopaedics. Genetics of musculoskeletal conditions and abnormalities are summarized in Table 1.27 > UPPER EXTREMITY > SHOULDER.

[25] Orthopaedic Knowledge Update Sports Medicine 6. Diagnostic Ultrasonography and Ultrasonography-­Guided Procedures > Annotated References.

[27] Apley And Solomon S Concise System Of Orthopaedics And Trauma. INVESTIGATION.

[30] Rockwood And Matsen S The Shoulder. Developmental Anatomy of the Shoulder and Anatomy of the Glenohumeral Joint > SENIOR EDITOR COMMENTARY.

[32] Rockwood And Green S Fractures In Adults. 29: Principles of Nonunion and Bone Defect Treatment > Magnetic Resonance Imaging and Arthrography.

[34] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Shoulder Anatomy and Biomechanics, Clinical Evaluation, Imaging > Clinical Evaluation > Imaging.

[35] Aaos Comprehensive Orthopaedic Review 3. Imaging of the Shoulder and Elbow > I. Shoulder.

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