WikiMSK:Featured Article/1 June 2025
Scapular Winging
Scapular winging is a dysfunction involving the stabilizing muscles of the scapula, resulting in imbalance, abnormal motion, and a prominence of the medial or vertebral border of the scapula. This may or may not be symptomatic.
Diagnosis is made clinically with the presence of excessive medializing scapular retraction (medial winging) or excessive lateralizing scapular protraction (lateral winging). The most common cause is long thoracic nerve palsy leading to serratus anterior weakness, often due to neuralgic amyotrophy. The second most common cause is spinal accessory nerve palsy causing trapezius weakness, which is frequently overlooked.
Treatment is generally observation, physical therapy, and activity modification. Operative intervention may be considered depending on the etiology of the winging and the presence of an identifiable neurological lesion.
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