Pectoralis Major Transfer for Medial Scapular Winging.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Reconstructive Surgery

Background:

• Scapular winging is a painful, functionally limiting condition often misdiagnosed.
• Medial scapular winging typically results from serratus anterior dysfunction due to long thoracic nerve palsy.
• Nonoperative management may succeed, but surgical intervention is an option for persistent cases.

Purpose of the Study:

• To evaluate the efficacy of pectoralis major transfer with hamstring autograft for treating medial scapular winging.
• To assess the surgical technique's impact on pain, shoulder motion, and functional recovery.

Main Methods:

• A 16-year-old female patient with symptomatic medial scapular winging underwent a 2-incision pectoralis major transfer with hamstring autograft augmentation.
• The procedure involved transferring the sternal head of the pectoralis major to the inferior scapular angle.
• Surgery was performed in the lateral position for optimal surgical access.

Main Results:

• At one-year follow-up, the patient experienced full, painless shoulder range of motion.
• Shoulder strength was graded as 5/5 in all tested planes.
• The patient successfully returned to all activities, including softball, without limitations.

Conclusions:

• Pectoralis major transfer with hamstring augmentation is a reliable surgical option for medial scapular winging.
• This procedure effectively alleviates pain and restores shoulder function in patients who have not responded to conservative treatment.
• Studies confirm improved motion, reduced pain, and enhanced function following this surgical intervention.