A Method of Resection of the Infraspinous Portion of the Scapula without Impairment of Shoulder Muscle Function

The following case is reported in order to illustrate .he operative procedure described below. Chief Complaint: A negro boy, seven years of age, came to the New Haven Dispensary with a complaint of pain and swelling about the left shoulder-blade. Present Illness: A swelling on the posterior aspect of the left shoulder had been noticed for two and one-half years. An elder brother was said to have been bouncing the patient on his knee and shortly afterward the swelling appeared. The shoulder has remained about the same as regards size and prominence since that time. The patient is not able to elevate the arm quite fully above the head. For the past year the shoulder has been painful and has disturbed him at night. Past History: The patient was a normal full-term baby. He has had pertussis, but no other childhood disease. He has had no operations or previous injuries. Family History: The mother and father are living and well, as are his six brothers and three sisters. The family history presents no significant facts. Physical Examination: Except for the local condition, the physical findings were entirely negative. The left scapula is prominent and is rotated on its axillary margin away from the median line. Motion of the scapula appears normal but is slightly limited in extremes. There is no redness or tenderness. On palpating the under surface of the vertebral border at the lower angle, there is felt a hard, irregular mass, about the size of a golf ball, which projects medially and downward. It is apparently attached to the scapula and moves with it. The mass lies under the trapezius and rhomboid muscles and has apparently stretched the latter so that they are somewhat weakened. This, and the presence of the mass, accounts for the slight limitation in extreme motion. (Fig. i)