Conservative and Surgical Management of Snapping Scapula

Authors: Francesco Soldati, Emma Torrance, Ravindra Badge, Lennard Funk

Introduction: Snapping scapula is uncommon and when symptomatic causes shoulder pain and dysfunction. The conservative and operative management of symptomatic snapping scapula are not well documented in the literature. 

Aims: In this study, we aim to assess the current management of snapping scapula and the subsequent patient outcomes.

Methods: Patients diagnosed with snapping scapula were retrospectively reviewed over 7 year period.  The diagnosis was made clinically, with MRI to exclude space-occupying lesions. There were no patients with space occupying lesions in this study. The cohort consisted of 45 patients (22 male, 23 female) with a mean age of 29.73±13.42 (15-70). All patients underwent specialist scapula rehabilitation for at least 6 months. Surgical cases involved an endoscopic scapulothoracic bursectomy and superomedial bony resection. 

Results: 45 patients were diagnosed with snapping scapula; 77.8% of the patients experienced complete relief of symptoms with physiotherapy alone (n=35), while 22.2% required a scapulothoracic bursal steroid injection (n=10). 13.3% of the injected patients failed to improve and were listed for surgery (n=6). An improvement in Constant outcome scores from 46.5±23.7 to 72.5±13.28 was observed across conservative and surgical cohorts.

Conclusion: The majority of patients with painful snapping scapula can be successfully managed with non-operative means. If this fails, then scapulothoracic bursectomy and superomedial bony resection is a viable option.