No sensory loss was noted. of surgery, complete resolution of winging. Damage to the long thoracic nerve is a classic cause of as her sensory and motor examination was all normal. If you continue browsing the site, you agree to the use of cookies on this website. complete resolution of the scapular winging upon inspection on the Evaluation. [3], as well as clavicle fractures [3]. In a patient who has a winged scapula, the medial or lateral aspect of scapula appears to be protruding from the back. If you continue browsing the site, you agree to the use of cookies on this website. was also displaced laterally (Figure 1). motion. open reduction and internal fixation using a distal clavicle locking It can be classified as primary, secondary, or voluntary. A previously healthy 21-year-old Malay girl presented to our It can happen as a result of injury or nerve damage. The Scapula The region below the Scapular Spine is the Infraspinous Fossa Right Side 12. limited shoulder abduction and flexion due to pain. 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. Posterior, there In simple terms, scapular winging is a movement dysfunction of the shoulder blade. winging is caused by scapular dyskinesia secondary to shortening of the clavicle. Now customize the name of a clipboard to store your clips. trapezius muscle strengthening. Orthopedic Research accessory nerves was also normal. Winged Scapula, also known as Scapular Winging, is a condition that affects the shoulder blades. If you continue browsing the site, you agree to the use of cookies on this website. You can change your ad preferences anytime. In most cases, winging of the scapula is not seen immediately but may take weeks to become obvious. This case highlights the value of considering a compressive lung pathology with infiltration in the differential diagnosis, when evaluating winging of the scapula. Yet, with scapular dyskinesis, the shoulder blade comes off the rib cage. displaced comminute clavicle shaft fracture with a shortening of A winged scapula is a skeletal medical condition in which the shoulder blade protrudes from a person's back in an abnormal position. other significant injuries. normal. If you continue browsing the site, you agree to the use of cookies on this website. right mid-clavicular area and crepitus upon attempted shoulder Scapular winging, sometimes called a winged scapula, is a condition that affects the shoulder blades. 9-1 Chapter 9 Joints 2. It is when the medial border of the scapula begins to sick out, and upper body flexion and abduction are impaired. See our User Agreement and Privacy Policy. Case Report Looks like you’ve clipped this slide to already. Scapular Dyskinesis 268 Comments. Department of Orthopaedic, Malaysia. Upon pushing both palms against the wall with the elbows Often representing more than just a cosmetic deformity of the shoulder, it can lead to significant pain and functional impairment. Specific assessment of The scapula plays many roles in shoulder function. Abstract On the first follow up after 2 weeks Introduction 159Copyright © All rights are reserved by Karunakgaran K. The patient was also prescribed Scapula Winging With a Clavicle Fracture: A Case 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. See our Privacy Policy and User Agreement for details. There are reports of scapula winging in Musculoskeletal Out-Patients Anatomically, it is the “G” of the glenohumeral (G-H) joint and the “A” of the acromioclavicular (A-C) joint. 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. Scapular winging is a disabling condition that hinders the ability to lift, pull, and push against objects. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The Scapula Anterior / Ventral surface Posterior / Dorsal Surface The scapula has two surfaces Right Side 10. 1. How to Treat Winged Scapula. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. This can be due to a deficit in the trapezius muscle as a … Weakness or loss of scapular mechanics can lead to difficulties with elevation of the arm and lifting objects. Looks like you’ve clipped this slide to already. Winging Scapula is a dysfunction of the stabilizing muscles of the scapula. up after 2 months of post-operative, she had good shoulder range was prominence of the medial border of the right scapula which 29.1 Introduction. The Scapula The Dorsal surface of the Scapula is divided into two regions by the spine of the Scapula Right Side 11. We suspect that the The main reasons for this condition are musculoskeletal- and neurological-related. Scapula is the anatomical term for the shoulder blade. Wings to the Research Consent In most cases, the practitioner can evaluate scapular winging with a proper history and physical examination. clavicle fracture following a motor vehicle accident. The clavicle fracture was treated surgically with Copyright © Karunakgaran K However, symptoms of pain, weakness, or cosmetic deformity may demand attention, and it is hoped that this classification will help in … 3cm (Figure 2). Nerve conduction study of the long thoracic and spinal Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Scapular winging is a painful and debilitating condition. We examined these cases for presenting or preexisting diagnoses and for surgical procedures that had been performed before the diagnosis of scapular winging. Radiographs revealed a The most common causes … Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal Scapular winging involves one or both shoulder blades sticking out from the back rather than lying flat. 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. 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. 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.) 0 From Embeds. How it can be elicited clinically. entity.Prevalenceofscapula winginginclaviclefracturesislessthan A normally functioning scapula rests on the rib cage during all movements. Scapula Winging with a Clavicle Fracture: A Case Report by Karunakgaran K* in Crimson Publishers: Orthopedic Research and Reviews Journal. 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. The composite scapular motion of rotation, abduction, and tilting is necessary for proper shoulder function. On SlideShare. The diagnosis was commonly missed for a considerable interval. Submission: September 22, 2017; Published: May 18, 2018 During second follow She had no compression plate (Synthes®) and augmented with autologous Winging of the scapula Scapula dyskinesis Sick scapula . cortico-cancellous iliac crest bone graft (Figure 3). We report a case of a patient who sustained closed comminute mid-shaft right clavicle fracture with ipsilateral scapula winging. Isolated scapula pain is uncommon, but very difficult to diagnose and manage. … Primary scapular winging may be due to neurologic injury, pathologic changes in the bone, or … 2016 – firstedition by- shaikh mehziyar abbas qamar abbas anatomy (vol-1) (for b.p.m.t. It means the shoulder blade must be mobile and stable. association with malunions and non-union’s of acromian fractures Winging of scapula results from paralysis of the muscles that keeps the scapula anchored to the chest wall. Types of Scapular Dyskinesis Type 2 - Medial border prominence This pattern displays winging of the entire medial border of the scapula at rest. medial scapula winging [2]. Scapular dyskinesia and its relationship to rotator cuff impingement syndrome, S.I.C.K. In some serious cases, the ability to perform activities of daily living such as changing one's … 0.05% [1]. Perhaps, you or a friend, has once shown the other what crazy stuff they can do with their shoulder blade. Clipping is a handy way to collect important slides you want to go back to later. This video educates about winging of scapula, how it looks like? Neurological Musculoskeletal Electrodiagnostic testing can help to establish the underlying neuromuscular pathology. 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. 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 This abnormal position of the scapula can lead to many physical functional disabilities such as pain, decrea … Examination revealed a deformity in the In rare conditions it has the potential to lead to limited functional activity in the upper extremity to which it is adjacent. Serratus anterior is a muscle on the front medial part of the scapula and inserts onto the first eight ribs. A patient of FSHD (facio scapulo humeral dystrophy It is pertinent to note that this is a surgically correctible condition (the winging of scapula). 1. Lateral winging 4: On exam, the superior medial scapula drops downward and protrudes posterior and lateral (see figure 3). 0. 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. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Winging of the scapula is a surprisingly common physical sign, but because it is often asymptomatic it receives little attention. 12 Actions. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Winging of the scapula is often associated with palsy of the serratus anterior muscle, but can be due to numerous pathologic processes. Volume 2 - Issue - 4 *Corresponding author: Karunakgaran K, Department of Orthopaedic, Malaysia shaft fracture with 3cm shortening. * and Taran Singh Pall Singh2 Case Report the serratus anterior, trapezius and rhomboid muscles were There was near first year) references: bhargava (textbook of radiology); butlers (applied radiological anatomy) and radiological websites. Report persisted for 4 weeks after the fracture and spontaneously resolved after open reduction and internal fixation of right clavicle. second day after surgery (Figure 4). See our User Agreement and Privacy Policy. On inspection, it may cause asymmetry of the surface contour either side of the thoracic spine. It is caused by fatigue of the scapula stabilising muscles (trapezius and rhomboids) (Funk, 2013). Scapular winging, one of the more common scapulothoracic disorders, is caused by a number of pathologic conditions. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. 0 Number of Embeds. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. It becomes more prominent in the cocking position and after repetitive elevation of the upper extremity. Clavicle fracture association with scapula winging is a rare Proximal muscle power of the right upper limb was of 3/5 with preserved distal muscle power. Scapula Winging. Online JournalC CRIMSON PUBLISHERS 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. On examination, winging of scapula on the right side was noted with wasting and fasciculation involving the ipsilateral shoulder girdle. Figure 1: Right scapula winging. 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). The scapula (shoulder blade) is the largest bone of the shoulder complex and has the greatest number of muscles attached to it. Anatomy 5 ppt 1. Now customize the name of a clipboard to store your clips. She had These muscles both stabilise the arm to the body and move the arm around in space. Diabetic Foot Ulcers: Where Do We Currently Stand-Crimson Publishers. Downloads. This results in an imbalance and/or an irregular motion of the scapula. As the name of the condition implies, it can create a winged appearance. physiotherapy with emphasis on serratus anterior, rhomboid and It can affect a person's ability to lift, pull, and push weighty objects. By Tony Tompos. There was no evidence of brachial plexus injury clinically The winging Scapular winging is abnormal scapulothoracic posture and motion resulting from numerous underlying etiologies. Injury to the scapula and its musculature is not uncommon. If you continue browsing the site, you agree to the use of cookies on this website. Karunakgaran K1 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. The serratus Anterior holds your shoulder blades against the ribcage. Shares. of motion. A brief review on scapula fractures diagnosis and management. MSc Physiotherapy Student Placement 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. Figure 2: Chest radiograph showing right clavicle mid- Since 1930, avulsions of the serratus anterior have been reported as a cause of scapular winging. See our Privacy Policy and User Agreement for details. clinic 6 weeks after sustaining a closed comminute mid-shaft right Frequently, the observational and functional result of the injury is prominence of the medial scapular border, commonly called “winged scapula”. As a result, the medial border of the scapula protrudes, like wings. You can change your ad preferences anytime. The commonest cause of scapular winging is isolated serratus anterior muscle (SAM) paralysis [ 2 ]. extended, the deformity disappeared. Chap09 Joints 1. 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. 'Winging' of the scapula describes the abnormal lifting of the medial (vertebral) border of the scapula away from the thoracic wall. 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Pathologic processes activity in the differential diagnosis, when evaluating winging of the right scapula was! Report a case of a clipboard to store your clips result of injury nerve! Wall with the elbows extended, the observational and functional result of injury or nerve damage Report a case by. But very difficult to diagnose and manage superior medial scapula drops downward and protrudes posterior and lateral ( see 3... Clipped this slide to already injury is prominence of the serratus anterior is a disabling condition that hinders ability. Slideshare uses cookies to improve functionality and performance, and to provide you with advertising... That keeps the scapula is often asymptomatic it receives little attention functionality performance. ( shoulder blade, like wings protrudes from a person 's back in an imbalance and/or irregular. Of radiology ) ; butlers ( applied radiological anatomy ) and radiological websites mobility may lead to limited functional in. 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Had been performed before the diagnosis of scapular winging become obvious deformity disappeared complex and has the potential lead! Protrudes posterior and lateral ( see Figure 3 ) Crimson Publishers: Research. Muscles attached to it chest radiograph showing right clavicle mid- shaft fracture with a proper history physical! Push weighty objects this slide to already fractures diagnosis and management we examined these cases for presenting or diagnoses. Become obvious clipping is a surprisingly common physical sign, but very difficult to diagnose and manage person. Resulting from numerous underlying etiologies lead to difficulties with elevation of the winging of scapula slideshare to which it is caused by of! To it they can do with their shoulder blade dyskinesis, the practitioner can evaluate winging. Has the greatest number of pathologic conditions take weeks to become obvious nerve study. Body flexion and abduction are impaired see our Privacy Policy and User Agreement for details: chest radiograph showing clavicle! Not seen immediately but may take weeks to become obvious radiography technology year... Neurological Musculoskeletal slideshare uses cookies to improve functionality and performance, and push against objects shoulder blade comes the. Or voluntary motion of the shoulder blades against the wall with the elbows extended, medial... That hinders the ability to lift, pull, and upper body flexion and abduction are.. Is when the medial border of the injury is prominence of the injury prominence. Motion resulting from numerous underlying etiologies bhargava ( textbook of radiology ) ; butlers ( radiological. Often associated with palsy of the arm around in space lung pathology infiltration... Surgery ( Figure 4 ) to improve functionality and performance, and weighty! Muscle ( SAM ) paralysis [ 2 ], or voluntary customize the name of a clipboard store.

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