Ho-ho-ho! Gather ’round, my elves, for I have a yuletide tale most unusual, not of reindeer or sleighs, but of a medical conundrum that befell a gentleman after a thoracotomy, which is no sleigh ride, I assure you. 🎅

In a land not so far away, a 52-year-old chap, let’s call him Nick, faced a grinchy lung sarcomatoid carcinoma that had its claws in his left upper chest wall. The surgeons, skilled as elves on Christmas Eve, embarked on a quest to excise the baddie, removing some ribs and muscles, but, alas, they left the chest wall without mending, like a stocking with no bottom.

Within a month, as the snow settled and the adjuvant therapy was delivered like presents under a tree, Nick was struck by a sharp pain, as if pricked by a holly leaf, and his left shoulder refused to jingle all the way. 🎄

The diagnosis? Left intrathoracic scapular prolapse, as rare as a white Christmas in July. The scapula, like a runaway sleigh, had slipped into a place it ought not to be. Nick, not keen on another adventure under the knife, opted for a closed manual reduction, a nifty trick where the scapula is coaxed back into place without opening the chest, much like I shimmy down chimneys.

Relief washed over him like the comfort of a warm fire, but, oh, the symptoms returned, as persistent as carolers on a cold night. After a few more rounds of this manual magic and a stern instruction to keep his shoulder from flying too high—no more than 90 degrees, like the angle of a perfect gingerbread roof—Nick’s shoulder stayed put for a year of observation, snug as a present under the tree.

So, my dear friends, if ever you encounter a scapular prolapse, remember that manual or surgical reduction are the toys in your sack. And if surgery is on the naughty list, manual reduction might just be the trick to ensure a merry and pain-free Christmas. 🎁

Now, back to toy-making! We have a schedule to keep! 🎅🤶