Scapular Winging

Scapular Winging

“…It has a mean length of 27 cm and diameter of 3 mm. Its course has considerable variation between individuals with direct penetration of C5 to the upper serratus in up to 65%, although it universally travels posterior to the axillary vessels and trunks of the brachial plexus and is found an average of 2.8 cm behind the clavicle [2,3,18]. In over half of individuals, the C5 and C6 contributions lie between the middle and posterior scalene, with the remainder travelling either through the middle scalene or anterior to the middle scalene [18].…”

“…Furthermore, diffuse paralysis of scapula stabilizers from fascioscapulohumeral dystrophy or brachial plexus injury and scapula bony abnormalities, including osteochondroma or fracture, can produce winging. Numerous other secondary causes of winging have been described, including voluntary or habitual winging [2,9].…”

“…Scapular winging is painful and incapacitating [1,2]. The composite movements of the scapula in rotation, abduction and tilting are essential for normal shoulder function and, if this anchored gliding of the scapula (against the posterior chest wall) is lost, then shoulder abduction can be limited to 90…”

Spinal Accessory Nerve Palsy: Associated Signs and Symptoms

“…2,6,9,11,[13][14][15][27][28][29]31,43,46,48,49,52,53 Neck dissection surgery is performed to treat head and neck carcinoma and is categorized into 3 different procedures: radical S pinal accessory nerve palsy (SANP) is common following neck dissection surgery or lymph node excision, 2,6,9,11,[13][14][15][27][28][29]31,43,46,48,49,52,53 blunt or penetrating trauma to the lateral neck region, 2,11 and cervical stretch injuries. 32 Spinal accessory nerve injury results in trapezius paralysis or dysfunction and a diagnostic cluster of signs and symptoms, including shoulder girdle depression, trapezius atrophy, scapular dyskinesis, loss of shoulder STUDY DESIGN: Retrospective case series.…”

Surgical Treatment of Winged Scapula

“…Multiple case series demonstrated good outcomes with the method described by Marmor and Bechtol [7,25,29] and now many authors advocate sternal head of pectoralis major transfer with either fascia lata or hamstring autograft supplementation for chronic serratus palsy [20,42]. A recent cadaveric study demonstrated the length of the sternal head of pectoralis is suitable for direct transfer to the inferior angle of the scapula [31].…”