Document Detail

Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation.
MedLine Citation:
PMID:  19111217     Owner:  NLM     Status:  MEDLINE    
PURPOSE: This study was aimed at evaluating whether scapular dyskinesis and, eventually, SICK (Scapular malposition, Inferior medial border prominence, Coracoid pain and malposition, and dysKinesis of scapular movement) scapula syndrome develop in patients with chronic type III acromioclavicular (AC) dislocation. METHODS: Scapulothoracic motion was studied in 34 patients with chronic AC dislocation by use of the protocol described by Kibler et al. and Burkhart et al. An anteroposterior radiograph of the scapulae with the arms abducted was also obtained. The SICK Scapula Rating Scale was applied to patients with SICK scapula syndrome. Shoulder function was assessed with the Constant score and Simple Shoulder Test (SST). RESULTS: Of the 34 patients, 24 (70.6%) had scapular dyskinesis with the arms at rest, and 14 of these (58.3%) had SICK scapula syndrome. The mean SICK Scapula Rating Scale score was 6.9 points (out of a possible 20 points). Clinical and radiographic evaluations with the arms abducted at 90 degrees confirmed scapular dyskinesis in 61.7% and 64.7% of patients, respectively (P > .05). The Constant score was 83 points for the pathologic side and 91 points for the contralateral side. The Constant score value was 75 and 88, respectively, in patients with dyskinesis and those without dyskinesis (P < .05); the mean value for the SST was 8 of 12 and 10 of 12, respectively. CONCLUSIONS: Chronic type III AC dislocation causes scapular dyskinesis in 70.6% of patients. Of the latter, 58.3% have SICK scapula syndrome develop. Dyskinesis might be due to loss of the stable fulcrum of the shoulder girdle represented by the AC joint and due to the superior shoulder pain caused by the dislocation. The values for the Constant score and SST were lower in patients with dyskinesis. LEVEL OF EVIDENCE: Level IV, prognostic case series.
Stefano Gumina; Stefano Carbone; Franco Postacchini
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-10-10
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  25     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-29     Completed Date:  2009-03-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  40-5     Citation Subset:  IM    
Department of Orthopaedic Surgery, University La Sapienza, Rome, Italy.
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MeSH Terms
Chronic Disease
Follow-Up Studies
Middle Aged
Movement Disorders / etiology*,  physiopathology,  radiography
Range of Motion, Articular / physiology*
Retrospective Studies
Scapula / injuries,  physiopathology*
Severity of Illness Index
Shoulder Dislocation / complications,  physiopathology*,  radiography
Shoulder Joint / injuries,  physiopathology*,  radiography
Trauma Severity Indices
Young Adult

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