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Scapular Winging: Evaluation and Treatment: AAOS Exhibit Selection.
Simon Lee1, David D Savin2, Neal R Shah2
1Department of Orthopaedic Surgery, University of Michigan Health System, 2912 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5328.
The Journal of Bone and Joint Surgery. American Volume
|October 23, 2015
Summary
Scapular winging, a disorder causing abnormal shoulder blade movement, often results from nerve injuries. Early diagnosis and treatment, including surgery for persistent cases, can lead to successful outcomes.
Area of Science:
- Orthopedics
- Neurology
- Sports Medicine
Background:
- Scapular winging is a rare but debilitating condition characterized by abnormal scapulothoracic kinematics.
- It can result in shoulder weakness, reduced range of motion, and significant pain.
- Common causes include injuries to the long thoracic nerve or spinal accessory nerve, leading to muscle imbalance.
Purpose of the Study:
- To summarize the etiology, diagnosis, and management of scapular winging.
- To highlight the importance of early diagnosis and treatment algorithms.
- To discuss surgical interventions for persistent cases.
Main Methods:
- Literature review of scapular winging causes and treatments.
- Analysis of diagnostic approaches for neuromuscular imbalances affecting the scapulothoracic region.
- Evaluation of non-surgical and surgical management strategies, including dynamic muscle transfers.
Main Results:
- Nonsurgical management is effective for most cases of scapular winging.
- Persistent symptoms despite conservative treatment may require surgical intervention.
- Dynamic muscle transfers demonstrate good clinical outcomes for refractory scapular winging.
Conclusions:
- Early diagnosis and a structured treatment approach are crucial for managing scapular winging.
- While non-surgical methods are often successful, surgical options like muscle transfers provide effective solutions for persistent cases.
- Understanding the neuromuscular basis of scapular winging guides successful treatment strategies.
