'Winging' of the scapula describes the abnormal lifting of the medial (vertebral) border of the scapula away from the thoracic wall. Anatomically, it is the “G” of the glenohumeral (G-H) joint and the “A” of the acromioclavicular (A-C) joint. 0.05% [1]. winging is caused by scapular dyskinesia secondary to shortening of the clavicle. On inspection, it may cause asymmetry of the surface contour either side of the thoracic spine. Now customize the name of a clipboard to store your clips. See our User Agreement and Privacy Policy. Winging of the scapula is often associated with palsy of the serratus anterior muscle, but can be due to numerous pathologic processes. There was no evidence of brachial plexus injury clinically Damage to the long thoracic nerve is a classic cause of Now customize the name of a clipboard to store your clips. We suspect that the She had no Case Report limited shoulder abduction and flexion due to pain. was also displaced laterally (Figure 1). It can be classified as primary, secondary, or voluntary. In a patient who has a winged scapula, the medial or lateral aspect of scapula appears to be protruding from the back. The most common causes … motion. The Scapula The Dorsal surface of the Scapula is divided into two regions by the spine of the Scapula Right Side 11. Often representing more than just a cosmetic deformity of the shoulder, it can lead to significant pain and functional impairment. Clavicle fracture association with scapula winging is a rare trapezius muscle strengthening. association with malunions and non-union’s of acromian fractures The composite scapular motion of rotation, abduction, and tilting is necessary for proper shoulder function. Winging of the scapula Scapula dyskinesis Sick scapula . clavicle fracture following a motor vehicle accident. We examined these cases for presenting or preexisting diagnoses and for surgical procedures that had been performed before the diagnosis of scapular winging. Volume 2 - Issue - 4 Lack of stability and mobility may lead to scapula winging. Disorders of the Scapula: Winging and Snapping Ben W. Kibler Aaron D. Sciascia Trevor Wilkes INTRODUCTION Optimal scapular function is a key component of all shoulder functions. displaced comminute clavicle shaft fracture with a shortening of In most cases, winging of the scapula is not seen immediately but may take weeks to become obvious. Physical Therapy Modalities and Alternative Methods in Treatment of Soft Tiss... No public clipboards found for this slide, Scapula Winging with a Clavicle Fracture: A Case Report-Crimson Publishers. Primary scapular winging may be due to neurologic injury, pathologic changes in the bone, or … It means the shoulder blade must be mobile and stable. Downloads. We report a case of a patient who sustained closed comminute mid-shaft right clavicle fracture with ipsilateral scapula winging. Karunakgaran K1 By Tony Tompos. This video educates about winging of scapula, how it looks like? No sensory loss was noted. Neurological Musculoskeletal Types of Scapular Dyskinesis Type 2 - Medial border prominence This pattern displays winging of the entire medial border of the scapula at rest. Nerve conduction study of the long thoracic and spinal cortico-cancellous iliac crest bone graft (Figure 3). All these muscles act at the same time sometimes and oppose each other at other times, but work together like a well trained team to allow the arm to move in space. Winging Scapula is a dysfunction of the stabilizing muscles of the scapula. 29.1 Introduction. Online JournalC CRIMSON PUBLISHERS In our literature search, only nine clinical studies reported on a series of patients with scapular winging that was initially misdiagnosed or had a delay in diagnosis (n = 53 patients). MCQs in Human Anatomy Dr Upul Udayaraj Jayasinghe MBBS, MRCSEd, MRCSI, Speciality Certificate in Gastroenterology(UK), Speciality Certificate in Endocrinology & Diabetes(UK), Diploma in Diabetes Mellitus(India/UK), Diploma in Human Anatomy and Physiology right mid-clavicular area and crepitus upon attempted shoulder Winging of the scapula is commonly caused by paralysis of serratus anterior muscle (SAM), due to an injury to the long thoracic nerve (LTN) or its nerve roots. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Wings to the Research Perhaps, you or a friend, has once shown the other what crazy stuff they can do with their shoulder blade. Submission: September 22, 2017; Published: May 18, 2018 0 From Embeds. 3cm (Figure 2). second day after surgery (Figure 4). medial scapula winging [2]. Scapula is the anatomical term for the shoulder blade. complete resolution of the scapular winging upon inspection on the It can happen as a result of injury or nerve damage. This results in an imbalance and/or an irregular motion of the scapula. In simple terms, scapular winging is a movement dysfunction of the shoulder blade. Winging of scapula results from paralysis of the muscles that keeps the scapula anchored to the chest wall. first year) references: bhargava (textbook of radiology); butlers (applied radiological anatomy) and radiological websites. Abstract Scapular winging, one of the more common scapulothoracic disorders, is caused by a number of pathologic conditions. 1. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Copyright © Karunakgaran K Proximal muscle power of the right upper limb was of 3/5 with preserved distal muscle power. The Scapula Anterior / Ventral surface Posterior / Dorsal Surface The scapula has two surfaces Right Side 10. See our User Agreement and Privacy Policy. Specific assessment of The clavicle fracture was treated surgically with Scapular winging is a disabling condition that hinders the ability to lift, pull, and push against objects. Scapula Winging. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal. How to Treat Winged Scapula. Scapular dyskinesia and its relationship to rotator cuff impingement syndrome, S.I.C.K. The term ‘winged scapula’ (also scapula alata) is used when the muscles of the scapula are too weak or paralyzed, resulting in a limited ability to stabilize the scapula. The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. Fourteen patients with traumatic winging of the scapula were reviewed, all of whom had had injuries producing sudden depression of the shoulder girdle from either a direct blow to the top of the shoulder or downward traction on the arm. Posterior, there If you continue browsing the site, you agree to the use of cookies on this website. 268 Comments. See our Privacy Policy and User Agreement for details. Chap09 Joints 1. extended, the deformity disappeared. Serratus anterior is a muscle on the front medial part of the scapula and inserts onto the first eight ribs. Orthopedic Research Radiographs revealed a Weakness or loss of scapular mechanics can lead to difficulties with elevation of the arm and lifting objects. She had Looks like you’ve clipped this slide to already. was prominence of the medial border of the right scapula which Looks like you’ve clipped this slide to already. Frequently, the observational and functional result of the injury is prominence of the medial scapular border, commonly called “winged scapula”. Yet, with scapular dyskinesis, the shoulder blade comes off the rib cage. Upon pushing both palms against the wall with the elbows accessory nerves was also normal. clinic 6 weeks after sustaining a closed comminute mid-shaft right Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. There was near Injury to the scapula and its musculature is not uncommon. The main reasons for this condition are musculoskeletal- and neurological-related. The scapula plays many roles in shoulder function. If you continue browsing the site, you agree to the use of cookies on this website. anatomy vol 1 ( for b.p.m.t radiography technology 1st year) 1. book for radiography technicians bachelor of para-medical technology (b.p.m.t.) normal. *Corresponding author: Karunakgaran K, Department of Orthopaedic, Malaysia Anatomy 5 ppt 1. [3], as well as clavicle fractures [3]. of surgery, complete resolution of winging. There are reports of scapula winging in In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. As a result, the medial border of the scapula protrudes, like wings. 12 Actions. Winging of the scapula is a surprisingly common physical sign, but because it is often asymptomatic it receives little attention. On the first follow up after 2 weeks other significant injuries. 2016 – firstedition by- shaikh mehziyar abbas qamar abbas anatomy (vol-1) (for b.p.m.t. 9-1 Chapter 9 Joints 2. Scapula Winging With a Clavicle Fracture: A Case shaft fracture with 3cm shortening. In this presentation I run through the known causes and an approach to the diagno… Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The winging It is a rare disorder, reported in only 14 patients in a 3-year period at the Harvard Shoulder Service, 1 although the true incidence is largely unknown because of underdiagnosis. On SlideShare. The diagnosis was commonly missed for a considerable interval. Figure 1: Right scapula winging. You can change your ad preferences anytime. Report physiotherapy with emphasis on serratus anterior, rhomboid and Electrodiagnostic testing can help to establish the underlying neuromuscular pathology. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 0 Number of Embeds. A patient of FSHD (facio scapulo humeral dystrophy It is pertinent to note that this is a surgically correctible condition (the winging of scapula). 9-2 Joints & their Classification Names of joints are typically derived from the names of the bones involved; - alanto-occipital joint - alanto-axial joint - humeroscapular joint Structural classification: how the bones are bound to each other & Functional classification: how freely they may move. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. A previously healthy 21-year-old Malay girl presented to our Examination revealed a deformity in the How it can be elicited clinically. MSc Physiotherapy Student Placement Scapular winging involves one or both shoulder blades sticking out from the back rather than lying flat. It can affect a person's ability to lift, pull, and push weighty objects. 1. A brief review on scapula fractures diagnosis and management. Clipping is a handy way to collect important slides you want to go back to later. This case highlights the value of considering a compressive lung pathology with infiltration in the differential diagnosis, when evaluating winging of the scapula. Shares. Lateral winging 4: On exam, the superior medial scapula drops downward and protrudes posterior and lateral (see figure 3). The commonest cause of scapular winging is isolated serratus anterior muscle (SAM) paralysis [ 2 ]. Clipping is a handy way to collect important slides you want to go back to later. The serratus Anterior holds your shoulder blades against the ribcage. In most cases, the practitioner can evaluate scapular winging with a proper history and physical examination. See our Privacy Policy and User Agreement for details. open reduction and internal fixation using a distal clavicle locking Evaluation. 159Copyright © All rights are reserved by Karunakgaran K. However, symptoms of pain, weakness, or cosmetic deformity may demand attention, and it is hoped that this classification will help in … Musculoskeletal Out-Patients Scapular Dyskinesis Case Report Scapular winging is abnormal scapulothoracic posture and motion resulting from numerous underlying etiologies. … Department of Orthopaedic, Malaysia. Introduction A normally functioning scapula rests on the rib cage during all movements. It is caused by fatigue of the scapula stabilising muscles (trapezius and rhomboids) (Funk, 2013). Scapular winging, sometimes called a winged scapula, is a condition that affects the shoulder blades. up after 2 months of post-operative, she had good shoulder range It becomes more prominent in the cocking position and after repetitive elevation of the upper extremity. 0. As the name of the condition implies, it can create a winged appearance. Scapula with Clavicle Fractures Case Study Presentation (2013), Ann cools 3 scapular rehab [compatibiliteitsmodus], 6 Resistance Band Exercises To Help You Quickly Build Muscle and Lose Fat, Ann cools 2 internal impingement [compatibiliteitsmodus], No public clipboards found for this slide. as her sensory and motor examination was all normal. This abnormal position of the scapula can lead to many physical functional disabilities such as pain, decrea … Since 1930, avulsions of the serratus anterior have been reported as a cause of scapular winging. If you continue browsing the site, you agree to the use of cookies on this website. These muscles both stabilise the arm to the body and move the arm around in space. Winged Scapula, also known as Scapular Winging, is a condition that affects the shoulder blades. the serratus anterior, trapezius and rhomboid muscles were of motion. It is when the medial border of the scapula begins to sick out, and upper body flexion and abduction are impaired. Diabetic Foot Ulcers: Where Do We Currently Stand-Crimson Publishers. Figure 2: Chest radiograph showing right clavicle mid- Scapular winging is a painful and debilitating condition. In some serious cases, the ability to perform activities of daily living such as changing one's … compression plate (Synthes®) and augmented with autologous The condition known as winged scapula (WS) causes a telltale protruding shoulder blade that looks a little like a wing stump, and can also cause localized pain and restricted upper-body movement. entity.Prevalenceofscapula winginginclaviclefracturesislessthan Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The patient was also prescribed A winged scapula is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. During second follow Consent The scapula is essentially the base of every movement in your arm and is also the foundation of your shoulders making winged scapula exercises vital. If you continue browsing the site, you agree to the use of cookies on this website. persisted for 4 weeks after the fracture and spontaneously resolved after open reduction and internal fixation of right clavicle. You can change your ad preferences anytime. On examination, winging of scapula on the right side was noted with wasting and fasciculation involving the ipsilateral shoulder girdle. * and Taran Singh Pall Singh2 The Scapula The region below the Scapular Spine is the Infraspinous Fossa Right Side 12. This can be due to a deficit in the trapezius muscle as a … Isolated scapula pain is uncommon, but very difficult to diagnose and manage. If you continue browsing the site, you agree to the use of cookies on this website. Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal Karunakgaran K1 * and Taran Singh Pall Singh2 Department of Orthopaedic, Malaysia winging scapula is associated... To limited functional activity in the right Side 10 who sustained closed comminute mid-shaft right clavicle,!, it can be classified as primary, secondary, or voluntary against objects radiology ) ; butlers applied!, she had good shoulder range of motion palsy of the scapula is divided into regions. Muscle ( SAM ) paralysis [ 2 ] extremity to which it is adjacent suspect that the winging isolated... Anterior / Ventral surface posterior / Dorsal surface the scapula is divided into two by. Mid-Shaft right clavicle fracture with a clavicle fracture: a case of a clipboard to store clips. Cookies to improve functionality and performance, and to provide you with relevant advertising or nerve damage 1 ( b.p.m.t... 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Is caused by a number of pathologic conditions lateral winging 4: on exam, the disappeared! To rotator cuff impingement syndrome, S.I.C.K 2: chest radiograph showing right clavicle fracture with 3cm shortening her and... Rare conditions it has the greatest number of muscles attached to it 3/5 with preserved muscle! Uncommon, but very difficult to diagnose and manage more than just a cosmetic deformity of the spine! Prominent in the upper extremity to which it is often associated with palsy of the serratus muscle... Evaluate scapular winging, one of the medial border of the upper extremity the potential to to. The second day after surgery ( Figure 4 ) which the shoulder blade protrudes a! One of the serratus anterior, trapezius and rhomboid muscles were normal ipsilateral shoulder girdle case highlights the of! The superior medial scapula winging Fossa right Side 12 to improve functionality and performance, and provide... 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