[Scapula alata following a gunshot injury]

The clinical condition "winged scapula" (scapula alata) is frequently not recognized as such. The accompanying symptoms are often attributed to more frequently occurring shoulder disorders, which can lead to unnecessary surgical procedures.

A 41-year-old man was shot during a robbery 3 years ago, resulting in a complete paraplegia from the fourth thoracic vertebra downwards. Within a year of the attack, during rehabilitation towards wheelchair use, he developed pain around his right shoulder. He also had diminished strength when extending his right arm and problems with trunk balance. These symptoms were long thought to be caused by shoulder overuse during wheelchair use, but turned out to be a consequence of injury to the long thoracic nerve.

Shoulder symptoms due to scapula alata can be caused be a penetrating wound leading to nerve injury. The treatment of patients with a scapula alata calls for a multidisciplinary approach.