Osteochondroma at the Ventro-Medial Surface of the Scapula Causing Pseudo Winging Scapular Resection with Computer-Assisted Navigation: A Case Report and Literature Review

Authors

  • Teerapat Nakornnoi, MD Department of Orthopedics, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand

DOI:

https://doi.org/10.56929/jseaortho-2024-0209

Keywords:

osteochondroma, scapular tumor, computer navigated axis surgery

Abstract

Purpose: Osteochondromas, the most common benign bone tumors, primarily occur in the long bones, with scapular osteochondromas constituting less than 1% of cases. A unique challenge in ventral scapular osteochondromas is limited visibility from the dorsal side. Computer-assisted surgery, which is widely employed in tumor surgery is a promising solution for minimally invasive resection with reduced muscle injury.

Methods: We present the case of a thirteen-year-old female with a ventral scapular osteochondroma that cause winging and snaping of her left arm. The patient underwent computer-assisted surgery under general anesthesia in the prone position. The procedure involved a minimal incision over the crest of the scapular spine, enabling precise identification of the tumor from the dorsal side using navigation tools.

Results: The tumor, identified as an osteochondroma on CT scans, was successfully resected with minimal soft tissue damage. Postoperatively, the patient's arm was immobilized for two weeks, followed by a pain-free return to normal activity. Radiographic evaluation confirmed complete tumor removal.

Conclusions: Computer-assisted navigation can help locate the ventral osteochondroma of the scapula with minimal soft tissue damage and a quicker recovery time.

Metrics

Metrics Loading ...

References

Alabdullrahman LW, Mabrouk A, Byerly DW. Osteochondroma. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing.

Kwon OS, Kelly JIV. Delayed presentation of osteochondroma on the ventral surface of the scapula. Int J Shoulder Surg 2012;6:61-3. DOI: https://doi.org/10.4103/0973-6042.96996

Aalderink K, Wolf B. Scapular osteochondroma treated with arthroscopic excision using prone positioning. Am J Orthop (Belle Mead NJ) 2010;39:E11-4.

Nascimento AT do, Claudio GK. Snapping scapula. Arthroscopic resection of osteochondroma of the subscapularis superomedial angle. Case report and literature review. Rev Bras Ortop 2017;52:220-3. DOI: https://doi.org/10.1016/j.rboe.2017.01.007

Pongkripetch M, Sirikulchayanonta V. Analysis of bone tumors in Ramathibodi Hospital, Thailand during 1977-1986: study of 652 cases. J Med Assoc Thai 1989;72:621-8.

Wong KC. A practical guide to computer assisted tumor surgery: CATS. Red Corporation Limited; 2010. DOI: https://doi.org/10.5772/14499

Prakash S, Kalra P, Khan Y, Dhal A. Ventral scapular osteochondroma excision through ‘triangle of auscultation’: A case series. J Orthop Surg (Hong Kong) 2020;28: 2309499019892848. DOI: https://doi.org/10.1177/2309499019892848

Tam MD, Laycock SD, Bell D, et al. 3-D printout of a DICOM file to aid surgical planning in a 6 year old patient with a large scapular osteochondroma complicating congenital diaphyseal aclasia. J Radiol Case Rep 2012;6:31-7. DOI: https://doi.org/10.3941/jrcr.v6i1.889

Pérez D, Ramón Cano J, Caballero J, et al. Minimally-invasive resection of a scapular osteochondroma. Interact Cardiovasc Thorac Surg 2011;13:468-70. DOI: https://doi.org/10.1510/icvts.2011.274621

Lazar MA, Kwon YW, Rokito AS. Snapping scapula syndrome. J Bone Joint Surg Am 2009;91:2251-62. DOI: https://doi.org/10.2106/JBJS.H.01347

Alshayhan FA, Alahaidib A, Alsowaigh M, et al. Bilateral scapular osteochondroma in Multiple Hereditary Exostosis patient presented with bilateral shoulder pain treated with arthroscopic and open excision: Case report. Ann Med Surg (Lond) 2021:67:102481. DOI: https://doi.org/10.1016/j.amsu.2021.102481

Orth P, Anagnostakos K, Fritsch E, et al. Static winging of the scapula caused by osteochondroma in adults: a case series. J Med Case Rep 2012:6:363. DOI: https://doi.org/10.1186/1752-1947-6-363

Chillemi C, Franceschini V, Ippolito G, et al. Osteochondroma as a cause of scapular winging in an adolescent: a case report and review of the literature. J Med Case Rep 2013;7:220. DOI: https://doi.org/10.1186/1752-1947-7-220

Sivananda P, RaO BK, Kumar PV, et al. Osteochondroma of the ventral scapula causing scapular static winging and secondary rib erosion. J Clin Diagn Res 2014;8:LD03-5. DOI: https://doi.org/10.7860/JCDR/2014/8129.4335

Tittal P, Pawar I, Kapoor SK. Pseudo-winging of scapula due to benign lesions of ventral surface of scapula–two unusual causes. J Clin Orthop Trauma 2015;6:30-5. DOI: https://doi.org/10.1016/j.jcot.2014.10.002

Flugstad NA, Sanger JR, Hackbarth DA. Pseudo-Winging of the Scapula Caused by Scapular Osteochondroma: Review of Literature and Case Report. Hand (N Y) 2015;10:353-6. DOI: https://doi.org/10.1007/s11552-014-9659-1

Alatassi R, Koaban S, Almugebel I, et al. Scapular osteochondroma with winging: A case report. Int J Surg Case Rep 2018;45:138-42. DOI: https://doi.org/10.1016/j.ijscr.2018.03.034

Pawar E, Modi N, Yadav AK, et al. A solitary ventral scapular osteochondroma causing pseudo-winging of scapula: A case report. J Orthop Case Rep 2021;11:82-5. DOI: https://doi.org/10.13107/jocr.2021.v11.i07.2328

Jindal V, Khandekar A, Gupta P, et al. Solitary osteochondroma of the scapula in a young male: A case report. J Orthop Case Rep 2022;12:34-7. DOI: https://doi.org/10.13107/jocr.2022.v12.i07.2906

Faur C, Abu-Awwad A, Patrascu Jr JM, et al. Superomedial scapula angle osteochondroma with winging in a young female patient—Case report and literature review. J Clin Med 2023;12:5106. DOI: https://doi.org/10.3390/jcm12155106

Downloads

Published

2024-06-24

How to Cite

1.
Nakornnoi T. Osteochondroma at the Ventro-Medial Surface of the Scapula Causing Pseudo Winging Scapular Resection with Computer-Assisted Navigation: A Case Report and Literature Review. JseaOrtho [Internet]. 2024 Jun. 24 [cited 2024 Nov. 21];48(2):40-3. Available from: https://jseaortho.org/index.php/jsao/article/view/209

Issue

Section

Case Reports