Scapular winging is a painful and debilitating condition. The composite scapular motion
of rotation, abduction, and tilting is necessary for proper shoulder function. Weakness
or loss of scapular mechanics can lead to difficulties with elevation of the arm and
lifting objects. The most common causes reported in the literature for scapular winging
are dysfunction of the serratus anterior from long thoracic nerve injury causing medial
winging or dysfunction of the trapezius from spinal accessory nerve injury causing
lateral winging. Most reviews and teaching focus on these etiologies. However, acute
traumatic tears of the serratus anterior, trapezius, and rhomboids off of the scapula
are important and under-recognized causes of scapular winging and dysfunction. This
article will review the relevant anatomy, etiology, clinical evaluation, diagnostic
testing, and treatment of scapular winging. It will also discuss the differences in
diagnosis and management between scapular winging arising from neurogenic causes and
traumatic muscular detachment.
Key words
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Article info
Publication history
Published online: October 03, 2018
Accepted:
August 1,
2018
Received:
March 28,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2018 by the American Society for Surgery of the Hand. All rights reserved.
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