The Treatment of Winged-Scapula

Zeier, Francis G.

doi:10.1097/00003086-197303000-00018

Cited by 32 publications

(8 citation statements)

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“…6,9,11,21 Neuritis of the brachial plexus or the long thoracic nerve is much less frequent. One case of a unilateral winging is reported with systemic lupus erythematosus, a viral infection with polio, or human parvovirus B.…”

Section: Discussionmentioning

confidence: 99%

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Operative treatment of a winged scapula due to peripheral nerve palsy in Lyme disease: A case report and review of the literature

Bischel¹,

Hempfing²,

Rickert³

et al. 2008

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

“…These muscles are attached to the paralytic serratus muscle or the lower pole of the scapula with or without augmentation by an autogenous tendon graft. 4,6,9,12,14,21 The use of the teres major muscle is also a possibility. 1 The tendon is detached from its humeral insertion and fixed directly to the fourth or fifth rib.…”

Section: Discussionmentioning

confidence: 99%

Operative treatment of a winged scapula due to peripheral nerve palsy in Lyme disease: A case report and review of the literature

Bischel¹,

Hempfing²,

Rickert³

et al. 2008

Journal of Shoulder and Elbow Surgery

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“…Trauma may also be due to repetitive movements, as seen in athletics [4, 13] and house-hold activities such as hedge-clipping [11], digging [11], car washing [57], or prolonged lying in bed with the arms abducted and propping up the head to read [7]. In addition, long thoracic nerve palsy may be due to direct mechanical pressure by an inflamed and enlarged subcoracoid or subscapular bursa along the pathway of the nerve [58].…”

Section: Etiologymentioning

confidence: 99%

“…Isolated serratus anterior palsy responds well to conservative treatment, with most cases functionally resolving within 1–24 months [3, 4, 9, 11, 13, 24, 25, 28, 35, 57, 63, 69]. Mild deficits in endurance functioning and asymptomatic scapular winging may persist after functional recovery [4, 11].…”

Section: Treatmentmentioning

confidence: 99%

Scapular winging: anatomical review, diagnosis, and treatments

Martin¹,

Fish²

2007

Curr Rev Musculoskelet Med

206

181

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Scapular winging is a rare debilitating condition that leads to limited functional activity of the upper extremity. It is the result of numerous causes, including traumatic, iatrogenic, and idiopathic processes that most often result in nerve injury and paralysis of either the serratus anterior, trapezius, or rhomboid muscles. Diagnosis is easily made upon visible inspection of the scapula, with serratus anterior paralysis resulting in medial winging of the scapula. This is in contrast to the lateral winging generated by trapezius and rhomboid paralysis. Most cases of serratus anterior paralysis spontaneously resolve within 24 months, while conservative treatment of trapezius paralysis is less effective. A conservative course of treatment is usually followed for rhomboid paralysis. To allow time for spontaneous recovery, a 6–24 month course of conservative treatment is often recommended, after which if there is no recovery, patients become candidates for corrective surgery.

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“…Multiple procedures describing muscle transfers for the treatment of scapular winging have been described and are beyond the scope of this text. 8,10,26,[33][34][35][36][37][38][39][40][41][42] Muscle transfers are not indicated in patients with progressive neuromuscular diseases such as facioscapulohumeral dystrophy. As stated earlier, scapulopexy procedures have fallen out of favor because the initial functional improvements seen with these procedures deteriorate with time due to stretching and loosening of the stabilizing constructs.…”

Section: Contraindicationsmentioning

confidence: 99%

Scapulothoracic Arthrodesis: Indications and Surgical Technique

Glenn

Romeo

2005

Techniques in Shoulder &Amp; Elbow Surgery

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Scapulothoracic motion accounts for approximately onethird of total shoulder elevation. Disorders affecting the muscles that attach to the scapula coordinating scapulothoracic motion or injury to the nerves that innervate these muscles can result in winging of the scapula and subsequent scapular dyskinesis. Examples include facioscapulohumeral dystrophy (FSHD), neuralgic amoyotrophy, poliomyelitis, long thoracic nerve palsy (affecting serratus anterior), spinal accessory nerve palsy (affecting trapezius), and dorsal scapular nerve palsy (affecting rhomboids and levator scapulae). Loss of scapular stabilization results in an unstable base for efficient glenohumeral motion, scapular winging, and subsequent loss of shoulder motion. Scapulothoracic arthrodesis provides rigid fixation of the scapula to the thorax, and long-term results of the procedure have generally been favorable. A surgical technique for scapulothoracic fusion and the results of the senior author's surgical experience are presented. n HISTORICAL PERSPECTIVEIn the past, patients with scapular winging were treated with orthotic devices that attempted to stabilize the scapula against the posterior chest wall. These devices were not well tolerated by patients, and efficacy was limited.

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The Treatment of Winged-Scapula

Cited by 32 publications

References 0 publications

Operative treatment of a winged scapula due to peripheral nerve palsy in Lyme disease: A case report and review of the literature

Operative treatment of a winged scapula due to peripheral nerve palsy in Lyme disease: A case report and review of the literature

Scapular winging: anatomical review, diagnosis, and treatments

Scapulothoracic Arthrodesis: Indications and Surgical Technique

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