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Case Reports in Orthopedics
Volume 2017, Article ID 8486739, 4 pages
https://doi.org/10.1155/2017/8486739
Case Report

Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection

Department of Orthopaedic Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0438, Japan

Correspondence should be addressed to Hideyuki Sasanuma; pj.ca.ihcij@uokasas

Received 9 August 2016; Revised 12 January 2017; Accepted 23 January 2017; Published 1 March 2017

Academic Editor: Johannes Mayr

Copyright © 2017 Akinori Kimura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report a case of recurrent locking of the scapula in the thorax after combined lobectomy and thoracic wall resection for advanced lung cancer. The patient was a 52-year-old man with advanced spindle cell carcinoma in his right lung. He had undergone right lung lobectomy and thoracic wall excision (Th1–5). Intrathoracic repair had not been performed to address the defect in the thoracic wall. Two months after the operation he experienced sudden acute pain in the right shoulder. Three-dimensional computed tomography revealed locking of the scapula intrathoracically. The diagnosis was recurrent locking of the scapula in the thorax. He underwent conservative treatment. Because his symptoms were not alleviated and he continued to experience recurrent locking, we performed partial resection of the inferior part of the scapula. Although scapular locking diminished after this procedure, there were still some pain and “catching” between the scapula and the thoracic wall (T6) when he undertook certain movements. No further surgery could be performed, however, because the cancer from the primary lesion had recurred near the previously operated thoracic wall. A procedure for recurrent intrathoracic locking of the scapula was not successful in this case.