title: Snapping scapular syndrome secondary to rib intramedullary fixation device.
abstract: BACKGROUND
  Scapulo-thoracic joint disorders, including bursitis and crepitus, are commonly misdiagnosed problems and can be a source of persistent pain and dysfunction
  
  
  METHODS
  This article describes an unusual case of a snapping scapula syndrome secondary to a migration through the lateral cortex of a rib splint intramedullary fixation device into the scapulothoracic joint.
  
  
  CONCLUSIONS
  Recently, the operative fixation of multiple ribs fractures with intramedullary fixation devices has become popular. Despite the good outcomes with new rib splint designs, concern remains about the potential complications related to potential loss of fracture reduction with migration of the wire resulting in pain or additional injury to the surrounding tissues.
  
  
  CONCLUSIONS
  Surgeons should pay attention to any protrusion of intramedullary rib implants, especially in the evaluation of routine X-rays following surgical treatment. We should be aware of the possibility of this rare cause of snapping scapula syndrome to avoid delayed diagnosis and consider removing the implant will resolve the pain.
authors.affiliation: Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina. Electronic address: ezequiel.zaidenberg@hospitalitaliano.org.ar.
authors.forename: Ezequiel E
authors.initials: EE
authors.lastname: Zaidenberg
authors.affiliation: Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Luciano A
authors.initials: LA
authors.lastname: Rossi
authors.affiliation: Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Santiago L
authors.initials: SL
authors.lastname: Bongiovanni
authors.affiliation: Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Tanoira
authors.affiliation: Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Gaston
authors.initials: G
authors.lastname: Maignon
authors.affiliation: Institute of Orthopaedics "Carlos E. Ottolenghi" Italian Hospital of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Ranalletta
keywords: Intramedullary nailing; Rib fixation; Snapping scapula