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