Year: 2005
Type: article
Study design: Case Report
Abstract: Winging scapula is uncommon clinically and easily ignored. It not only leads to a limited range of motion of the upper extremities, but impairs functional activity and body appearance as well. Many etiologies can induce winging scapula, including trauma, infection, iatrogenic injury, congenital abnormality, and the impairment of periscapular nerves, muscles, bones and joints. Traumatic winging scapula is often the result of long thoracic nerve, spinal accessory nerve, or dorsal scapula nerve stretch or compression, which causes weakness and atrophy of the serratus anterior muscle, trapezius muscle, or rhomboid muscle. Winging scapula due to disuse atrophy of the traumatic trapezius muscle is rare, but the prognosis is good.This report presents the case of a 28-year-old male who suffered from multiple abrasion wounds on the left-side limbs and a limitation of range of motion (ROM) of the left upper arm due to a motorcycle accident. There was no evidence of any bony abnormality in the initial X-ray checkup. One year later, physical examination revealed a left winging scapula with persistent left arm weakness, and an associated ROM limitation of the left shoulder, so brachial plexopathy or another peripheral neuropathy was suspected. A series of image studies and electrophysiological examinations were performed, but peripheral neuropathy was excluded. Winging scapula secondary to traumatic trapezius muscle disuse atrophy was diagnosed. After aggressive rehabilitation, the ROM of the left shoulder was much improved and the winging scapula also disappeared. Thus, for the patient suspected of having winging scapula, a detailed history-taking, physical examination, and image study are very important. Furthermore, nerve conduction studies and electromyography examinations can help physicians define the correct etiology of the winging scapula, and whether it is combined with nerve injury. An appropriate rehabilitation program is essential to improve the patient's functional activity and body appearance.
DOI: 10.6315/2005.33(3)07
Author: Tsung-Ching Lin
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4390768752