Dynamic stabilization of winging scapula by direct split pectoralis major transfer: a technical note

Area of Science:

• Orthopedic surgery
• Musculoskeletal research
• Surgical innovation

Background:

• Scapular winging can result from various conditions affecting shoulder and chest muscles.
• Current surgical treatments often involve tendon grafts, which can lead to complications.
• A simpler, effective surgical solution for scapular winging is needed.

Purpose of the Study:

• To present a new surgical technique for scapular winging using a split pectoralis major tendon transfer.
• To evaluate the feasibility and potential benefits of direct tendon attachment compared to graft-based methods.

Main Methods:

• A novel technique involving a split pectoralis major tendon transfer (sternal head) is described.
• The procedure utilizes anterior and posterior incisions for tendon mobilization.
• Direct transosseous fixation of the transferred tendon to the inferior angle of the scapula is performed.

Main Results:

• Anatomic study indicates pectoralis major muscle suitability for the described transfer.
• The technique allows direct attachment, eliminating the need for autogenous grafts.
• This method avoids concerns associated with graft stretching or tearing.

Conclusions:

• The described split pectoralis major tendon transfer offers a promising alternative for correcting symptomatic scapular winging.
• Direct transosseous fixation simplifies the procedure and potentially reduces complications.
• This technique provides an effective solution without requiring autogenous grafts.