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

A new technique of split pectoralis major tendon transfer (sternal head) for symptomatic scapular winging is shown. Whereas other authors use a lengthening with autogenous grafts, we prefer a direct attachment of the split pectoralis major tendon. With the use of an anterior and a posterior incision, the tendon of the sternal head of the pectoralis major is mobilized and transferred directly to the inferior angle of the scapula. An anatomic study shows that the pectoralis major muscle usually seems to be suitable for this procedure. Direct transosseous fixation of the transferred split pectoralis major tendon appears to be an excellent operation for correcting winging scapula without the necessity of an autogenous graft and concern over stretching or tearing of the graft extension.