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Related Experiment Videos

[A winged scapula].

C G Faber1, M M Klaver, J H J Wokke

  • 1Academisch Ziekenhuis Maastricht, afd. Neurologie, Postbus 5800, 6202 AZ Maastricht. cfa@sneu.azm.nl

Nederlands Tijdschrift Voor Geneeskunde
|October 3, 2002
PubMed
Summary
This summary is machine-generated.

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Scapular winging can result from nerve injuries affecting the long thoracic nerve or accessory nerve. While long thoracic nerve injuries often improve, accessory nerve lesions have a poorer prognosis.

Area of Science:

  • Neurology
  • Orthopedics
  • Anatomy

Background:

  • Scapular winging is a clinical sign indicating underlying neuromuscular dysfunction.
  • It can arise from various nerve pathologies affecting shoulder girdle stability.

Observation:

  • Three patients presented with scapular winging due to different nerve conditions: amyotrophic plexus neuralgia, long thoracic nerve injury, and accessory nerve palsy.
  • Specific clinical tests differentiate the affected muscles and nerves based on arm movement.

Findings:

  • Paresis of the serratus anterior (long thoracic nerve) showed improvement in two patients within 9 months to 1.5 years.
  • Paresis of the trapezius muscle (accessory nerve) resulted in persistent scapular winging in one patient after 11 years.
  • Electromyography (EMG) is crucial for accurate diagnosis.

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Implications:

  • Prognosis varies significantly based on the affected nerve; long thoracic nerve lesions generally have a better outlook than accessory nerve lesions.
  • Understanding the specific nerve involvement is key for predicting recovery and guiding treatment for scapular winging.
  • Fascioscapulohumeral muscular dystrophy (FSHD) is another differential diagnosis for scapular winging.