Scapulothoracic Arthroscopy

Abstract

Resection of the superomedial corner of the scapula has traditionally been performed using an open technique. Despite good functional results, the large incision necessary to visualize both the scapula and scapulothoracic bursa often resulted in poor cosmesis in this young patient group. Arthroscopic techniques can be technically demanding, and the lack of bony landmarks can create difficulty in orientation and potential risk for surrounding nerves. The use of a superior (Bell) portal has previously been reported and has been in clinical use without any complications. We describe a safer arthroscopic technique for resection of bone from the superomedial scapular corner using both landmarks from the scapula and landmarks created by using the Bell portal. The risk for iatrogenic nerve damage is greatly reduced if the instruments are not directed beyond the arthroscopic resection target located at the center of the medial scapular border. This is an important improvement in the technique of arthroscopic scapulothoracic surgery.