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A winged scapula (scapula alata) is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. It can affect a person's ability to lift, pull, and push weighty objects.
The dorsal scapular nerve is a branch of the brachial plexus, usually derived from the ventral ramus of cervical nerve C5. It provides motor innervation to the rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. Dorsal scapular nerve syndrome can cause a winged scapula, with pain and limited motion.
There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
Poor strength or limited movement are suggestive of damage, which can result from a variety of causes. Injury to the spinal accessory nerve is most commonly caused by medical procedures that involve the head and neck. [4] Injury can cause wasting of the shoulder muscles, winging of the scapula, and weakness of shoulder abduction and external ...
Orthopedic surgery address foot deformities, scoliosis, Achilles tendon contractures, and winged scapula. Winged scapula can be addressed with either scapulopexy or scapulothoracic fusion. [1] Circumstances to avoid include extremes of body weight, bone fractures, and prolonged immobility. [1]
Facioscapulohumeral muscular dystrophy (FSHD) is a type of muscular dystrophy, a group of heritable diseases that cause degeneration of muscle and progressive weakness. Per the name, FSHD tends to sequentially weaken the muscles of the face, those that position the scapula, and those overlying the humerus bone of the upper arm.
Later, the muscles that position the scapula can be weakened, completing a pattern that is termed 'scapulohumeroperoneal'. [12] [1] Weakness of the scapular fixators can cause a winged scapula, [1] which can impair the ability to lift the arms over the head and can be painful.
Symptoms are often minimal – if symptomatic, a posterior shoulder or scapular burning type of pain may be reported. Some injuries, particularly lesions, can paralyse the serratus anterior muscle to produce a winged scapula. [3] [12] This is most prominent when the arm is lifted forward or when the patient pushes the outstretched arm against a ...