Pectoralis major transfer for winging of the scapula

From November 1988 to July 1992 eight patients with painful, chronic, disabling winging of the scapula caused by isolated serratus anterior paralysis had pectoralis major muscle transfer extended by a fascia lata graft. Six men and two women were treated. Duration of symptoms ranged from 12 to 35 months. Seven patients had a positive result on electromyography. In addition, four patients had multidirectional instability of the shoulder on the side of the winging. The postoperative follow-up period ranged from 12 to 57 months (average 27.1 months). Excellent results were obtained in all patients. In addition, patients with associated multidirectional instability improved, and only one subsequently required additional shoulder surgery. The described method of coiling and suturing the donor graft is believed to account for the consistent results and absence of substantial complications. Pectoralis major muscle transfer extended by a fascia lata graft appears to be an excellent operation for correcting scapular winging.