Scapular Winging or Winged Scapula

Clinical Image

Winged scapula results from insufficient dynamic fixation of the scapula to the thorax secondary to neuromuscular impairment. Winged scapula is rare but causes significant functional limitations. It is the consequence of neuromotor deficits in one of the scapulothoracic muscles that stabilize the scapula: the serratus anterior, trapezius, rhomboid major and minor, and levator scapulae. The two most common causes of winged scapula are; damage to the long thoracic nerve, which innervates the serratus anterior muscle and damage to the accessory nerve, which innervates the trapezius muscle. Electroneuromyography confirms the diagnosis.

    

    

    Figure 1: Bilateral winged scapula in a 16-year-old boy due to bilateral
involvement of the long thoracic nerve.