Tendon Transfers for Scapular Winging

Abstract

Scapular winging is an uncommon shoulder disorder often caused by a disruption of the neuromuscular unit of the scapulothoracic articulation, leading to abnormalities in scapular posture and altered scapulothoracic motion and stabilization. Lesions of the long thoracic or spinal accessory nerves, causing serratus anterior palsy or trapezius palsy, respectively, are common etiologies. Patients classically report burning periscapular pain with muscle weakness and fatigue, which can be highly debilitating, particularly with overhead activities. Most patients do well with nonsurgical treatment consisting of rest, use of anti-inflammatory medications, and sometimes brief sling immobilization. Surgical treatment for scapular winging involves the use of tendon transfers, directed at restoring scapular stability, strength, and function.

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